Paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia
Other namesSupraventricular tachycardia, paroxysmal atrial tachycardia (PAT)[1]
Lead II electrocardiogram strip showing PSVT with a heart rate of about 180.
SpecialtyEmergency medicine, cardiology
SymptomsPalpitations, feeling lightheaded, increased heart rate, sweating, shortness of breath, chest pain[2]
Usual onsetStarts and stops suddenly[3]
CausesNot known[3]
Risk factorsAlcohol, caffeine, nicotine, psychological stress, Wolff-Parkinson-White syndrome[3]
Diagnostic methodElectrocardiogram[3]
PreventionCatheter ablation[3]
TreatmentValsalva maneuver, adenosine, calcium channel blockers, synchronized cardioversion[4]
PrognosisGenerally good[3]
Frequency2.3 per 1000 people[5]

Paroxysmal supraventricular tachycardia (PSVT) is a type of supraventricular tachycardia, named for its intermittent episodes of abrupt onset and termination.[3][6] Often people have no symptoms.[1] Otherwise symptoms may include palpitations, feeling lightheaded, sweating, shortness of breath, and chest pain.[2]

The cause is not known.[3] Risk factors include alcohol, psychostimulants such as caffeine, nicotine, and amphetamines, psychological stress, and Wolff-Parkinson-White syndrome, which often is inherited.[3] The underlying mechanism typically involves an accessory pathway that results in re-entry.[3] Diagnosis is typically by an electrocardiogram (ECG) which shows narrow QRS complexes and a fast heart rhythm typically between 150 and 240 beats per minute.[3]

Vagal maneuvers, such as the Valsalva maneuver, are often used as the initial treatment.[4] If not effective and the person has a normal blood pressure the medication adenosine may be tried.[4] If adenosine is not effective a calcium channel blocker or beta blocker may be used.[4] Otherwise synchronized cardioversion is the treatment.[4] Future episodes can be prevented by catheter ablation.[3]

About 2.3 per 1000 people have paroxysmal supraventricular tachycardia.[5] Problems typically begin in those 12 to 45 years old.[3][5] Women are more often affected than men.[3] Outcomes are generally good in those who otherwise have a normal heart.[3] An ultrasound of the heart may be done to rule out underlying heart problems.[1]

  1. ^ a b c Ferri's Clinical Advisor 2013,5 Books in 1, Expert Consult - Online and Print,1: Ferri's Clinical Advisor 2013. Elsevier Health Sciences. 2012. p. 807. ISBN 978-0323083737. Archived from the original on 2 October 2016.
  2. ^ a b "What Are the Signs and Symptoms of an Arrhythmia?". NHLBI. 1 July 2011. Archived from the original on 19 February 2015. Retrieved 27 September 2016.
  3. ^ a b c d e f g h i j k l m n o Al-Zaiti SS, Magdic KS (September 2016). "Paroxysmal Supraventricular Tachycardia: Pathophysiology, Diagnosis, and Management". Critical Care Nursing Clinics of North America. 28 (3): 309–16. doi:10.1016/j.cnc.2016.04.005. PMID 27484659.
  4. ^ a b c d e Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, De Caen AR, Donnino MW, Ferrer JM, Kleinman ME, Kronick SL, Lavonas EJ, Link MS, Mancini ME, Morrison LJ, O'Connor RE, Samson RA, Schexnayder SM, Singletary EM, Sinz EH, Travers AH, Wyckoff MH, Hazinski MF (3 November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–67. doi:10.1161/cir.0000000000000252. PMID 26472989.
  5. ^ a b c Katritsis (2016). Clinical Cardiology: Current Practice Guidelines. Oxford University Press. p. 538. ISBN 9780198733324. Archived from the original on 2 October 2016.
  6. ^ "Types of Arrhythmia". NHLBI. 1 July 2011. Archived from the original on 7 June 2015. Retrieved 29 September 2016.