Sudden onset of ventricular bigeminy just before induction of anesthesia in child

There are many causes of premature ventricular contractions in pediatric patients with structurally or functionally normal hearts. We report a case of a pediatric patient who suddenly developed ventricular bigeminy during the pre-induction period for general anesthesia. Predisposing heart disease was evaluated by urgent cardiac consultation and the cause of the transient ventricular bigeminy was traced to preoperative anxiety. The child was successfully managed with non-pharmacological preparation. We emphasize that physicians should ruminate on PVCs related to anxiety just before induction and conduct a timely, adequate work-up to exclude underlying cardiac pathology in pediatric patients.