We report a case of a patient admitted to the neonatal intensive care unit at birth for grunting and respiratory distress. A diagnosis was made after the patient presented with signs of serious poor perfusion and cardiorespiratory monitoring showed a rapid cardiac rhythm suggesting supraventricular tachycardia (SVT). Hemodynamic stability was achieved after several adenosine boluses and the SVT was reverted. Episodes of SVT are characterized by abrupt onset and termination and regular narrow QRS complex tachycardia without P waves. This diagnosis should be kept in mind in neonates when a sudden vascular change resembling cutis marmorata happens since it can suggest cardiogenic shock caused by an underlying arrhythmia.