Causes of Apparent Life Threatening Event (ALTE) - Differential Diagnosis Algorithm

Cardiac:

 • Congenital Heart Disease

 • Arrhythmia

 • Cardiomyopathy

 • Myocarditis 

Metabolic:

 • Inborn Errors of Metabolism

 • Reye's Syndrome

 • Electrolyte Disturbances 

Neurologic:

 • Seizure

 • Malignancy

 • Neuromuscular

 • Disorders

 • Central Apnea

Respiratory:

 • Anatomical Foreign Body Aspiration

 • Breath-holding spell (age-dependent)

Infectious:

 • Pneumonia

 • Sepsis

 • Upper Respiratory Tract Infection

 • Empyema

 • Urinary Tract Infection

Gastrointestinal:

 • Gastroesophageal Reflux

 • Volvulus

 • Gastroenteritis

 • Incarcerated Hernia

Witnessed Choking Spell 

Injury:

 • Non-Accidental

 • Unnoticed

 • Factitious by Proxy 

Apnea:

 • Periodic Breathing

 • Apnea of Infancy



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