undergo a pericardial drainage procedure (e.g., placement of a pericardial catheter percutaneously under ultrasound guidance and/or pericardial window procedure) Acute rheumatic fever follows pharyngeal streptococcal infection and is an inflammatory disease that targets the heart, vessels, joints, skin, and central nervous system (CNS) Diagnosis and management of acute rheumatic fever are discussed separately (see Chapter 86 Cardiac Emergencies ) Clinical criteria for Kawasaki disease consist of prolonged high fever, conjunctivitis with perilimbic sparing, “strawberry tongue,” painful swelling of the hands and feet, rash, and lymphadenopathy Early recognition and treatment of Kawasaki disease with intravenous γ-globulin is necessary to prevent the development of coronary artery aneurysms with potential for myocardial ischemia (see Chapter 101 Rheumatologic Emergencies ) Patients with thyroid storm may have marked sinus tachycardia, fever, goiter, and CNS stimulation (agitation, delirium, psychosis, seizures) accompanied by congestive heart failure (see Chapter 89 Endocrine Emergencies ) Trauma, thyroid infection, thyroid surgery, and acute iodine load are frequent precipitants Rapid recognition and institution of therapy to treat adrenergic symptoms (βadrenergic blockers), block hormone synthesis (methimazole), prevent peripheral conversion of T4 to T3 (iodinated radiocontrast agents), and prevent thyroid hormone release (iodine) are necessary to prevent mortality Crying, pain, or anxiety is the most frequent cause of sinus tachycardia in afebrile children Drug ingestion, poisoning, and anemia are important additional considerations (see Table 63.4 ) Rarely, sinus tachycardia may herald the presence of hyperthyroidism or pheochromocytoma, a catecholamine-secreting tumor that causes extreme hypertension, diaphoresis, and flushing (see Chapter 89 Endocrine Emergencies ) Suggested Readings and Key References American Heart Association Pediatric Advanced Life Support Provider Manual Dallas, TX: American Heart Association; 2016 Fleming S, Thompson M, Stevens R, et al Normal ranges of heart rate and respiratory rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies Lancet 2011;377:1011–1018 Fuchs S, Yamamoto L, eds APLS: The Pediatric Emergency Medicine Resource 5th ed Burlington, MA: Jones & Bartlett Learning; 2012 Mazor S, Mazor R Approach to the child with tachycardia UpToDate Available online at www.uptodate.com Accessed April 18, 2019