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Supraventricular tachycardia (SVT) is one of the most common arrhythmias in the pediatric population, often resulting from re-entry mechanisms involving accessory pathways or dual atrioventricular nodal physiology. Although generally well tolerated in children with structurally normal hearts, its management can be challenging, particularly in recurrent or persistent cases. This study is a case report describing a pediatric patient with hemodynamically stable SVT treated at Dr. Wahidin Sudirohusodo Hospital. Data were collected retrospectively from medical records, including history taking, physical examination, and supporting investigations such as serial electrocardiography (ECG), laboratory tests, chest radiography, and transthoracic echocardiography. Management was conducted according to current clinical guidelines, including vagal maneuvers, pharmacological therapy with beta-blockers and antiarrhythmic agents (amiodarone), and monitoring of treatment response based on clinical evaluation and ECG, along with identification and treatment of underlying triggers. We report a case of a 10-year-old female presenting with suspected SVT and pericarditis, who experienced episodes of narrow QRS complex tachycardia that were successfully converted to sinus rhythm following amiodarone administration. Echocardiographic evaluation revealed mild to moderate tricuspid regurgitation with preserved ventricular function. Laboratory and radiological findings suggested an underlying inflammatory process, which was considered a triggering factor. This case highlights the importance of a comprehensive approach in the diagnosis and management of pediatric SVT, including addressing underlying conditions and ensuring continuous monitoring to prevent recurrence.

Extreme changes in water quality, whether in the form of temperature fluctuations, exposure to detergents, pH decreases due to acetic acid, or changes in salinity, have the potential to cause complex physiological disorders in tilapia. The research aims to analyze the physiological responses of tilapia to changes in water quality in extreme environments given exposure to Temperature, Detergent, Acetic Acid, and Salinity. This research was conducted at the Wet Laboratory of Achmad Yani University, Banjarmasin. The physiological parameters observed included fish behavior, respiratory frequency measured by the number of openings and closings of the operculum per minute, gill condition, and mucus production on the body surface. Exposure to extreme environments in the form of high temperatures, detergents, acetic acid, and salinity caused physiological disorders in tilapia with varying levels of response. Exposure to acetic acid had the most rapid and severe impact, characterized by damage to scales and fins, impaired movement to the point of fish capsizing, and unstable breathing, while detergent and temperature triggered changes in external organs, heart rate, and behavior. Salinity treatment primarily affected osmoregulatory function as seen from increased respiratory frequency and heart rate. All treatments showed that extreme changes in water quality can cause significant physiological stress in tilapia.