14 terms

PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

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paroxysmal supraventricular tachycardia (PSVT)
an episodic condition with an abrupt onset and termination
supraventricular tachycardia (SVT)
any tachyarrhythmia that requires atrial and/or atrioventricular (AV) nodal tissue for its initiation and maintenance. narrow-complex, regular, rapid rhythm; (medscape)
PSVT etiologies
Reentry mechanism. May be induced by premature atrial or ventricular ectopic beats, hyperthyroidism and stimulants, including caffeine, drugs, and alcohol. (medscape)
PSVT patient population
healthy individuals; previous MI, mitral valve prolapse, rheumatic heart disease, pericarditis, pneumonia, chronic lung disease, current alcohol intoxication,Digoxin toxicity (medscape)
Sinus tachycardia
most common SVT. accelerated sinus rate that is a physiologic response to a stressor. regular rhythm, HR>100
sinus tachycardia etiologies
hypoxia, hypovolemia, fever, anxiety, pain, hyperthyroidism, exercise, nicotine, caffeine, atropine, cocaine, amphetamines, ecstasy; and hydralazine
sinus tachycardia treatment
treat underlying cause
AV nodal reentrant tachycardia (AVNRT)
The most common cause of paroxysmal SVT. w/ regular narrow QRS tachyarrhythmia. HR= 120-250 bpm
AV nodal reentrant tachycardia (AVNRT) .
healthy, young individuals, middle age and WOMEN. Most do not have structural heart disease
prognosis of PSVT
heart failure, pulmonary edema, myocardial ischemia, and/or myocardial infarction
symptoms of paroxysmal SVT
Palpitations, Dizziness, Shortness of breath, Syncope, Chest pain, fatigue, Diaphoresis, Nausea
diagnosis of PSVT
ECG: narrow QRS complexes, rapid, and regular
treatment of SVT
Vagotonic maneuvers [Valsalva maneuver, unilateral carotid sinus massage, ice water facial immersion, swallowing of ice-cold water] ; Adenosine; Verapamil, or diltiazem if narrow QRS complex. For frequent recurrence, radiofrequency ablation
Avoid AV nodal blockers for wide complex tachycardia. Instead use ______ or _______or _________.
synchronized cardioversion; procainamide; amiodarone