Apparent Life-Threatening Event
Alternate Names : Apnea Spell, Infant Apnea, Acute Life-Threatening Episode, ALTE
An apparent life-threatening event, or ALTE, is sometimes referred to
as a prolonged infant apnea spell. It is an episode in which an infant has apnea,
or stops breathing for a short time. The episode lasts long enough to cause:
choking and gagging
color change in the skin and lips, first bright red then blue
muscle weakness and limpness
Babies often breathe in cycles. That is, they alternate rapid
breathing with slow breathing. This can be normal. Apnea, however, occurs
when the baby has an episode of not breathing at all that lasts for more than
20 seconds.
What is going on in the body?
What occurs in the body during an ALTE depends on the cause of
the episode. A heart or lung problem may cause an infant to temporarily stop
breathing. As the lack of breathing continues, the infant may start to struggle
for air, cough, and gag. Eventually, as the oxygen level in the blood decreases,
the infant may become limp and pale and then may turn blue. This can occur both
when an infant is sleeping or when the baby is playing and active. Sometimes
simply touching the infant or picking the infant up will make him or her start
breathing again. In other cases, advanced medical support may be needed.
What are the causes and risks of the condition?
Potential causes of ALTE include:
a viral infection such as respiratory syncytial virus,
also known as RSV
a bacterial infection such as pneumonia
something blocking the infant's airway, such as food that was inhaled into the
windpipe or an abnormally narrow airway
cardiac arrhythmia,
which is an abnormal heart rhythm
cardiomyopathy,
which is an abnormal growth of the heart muscle
gastrointestinal conditions, such as gastroesophageal reflux disorder,
also known as GERD
respiratory conditions, such as whooping cough
neurological disorders, such as seizures,
meningitis,
or brain tumors
Munchausen syndrome
by proxy, a parenting disorder in which a parent fabricates symptoms in the child
In approximately 50% of cases of ALTE, the cause is not found.
Infants who are born prematurely
may be at greater risk for an ALTE. Infants who have a history of respiratory or
cardiac problems, such as congenital heart disease,
may also be at greater risk for ALTE. Infants with other family members who
have had episodes of ALTE may also be more at risk.
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