Paroxysmal supraventricular tachycardia

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Paroxysmal supraventricular tachycardia
ECG showing paroxysmal supraventricular tachycardia
Synonyms	PSVT, supraventricular tachycardia
Pronounce	N/A
Specialty	N/A
Symptoms	Palpitations, dizziness, shortness of breath, chest pain
Complications	N/A
Onset	Sudden
Duration	Episodes can last from a few seconds to several hours
Types	N/A
Causes	Re-entry circuit in the atrioventricular node or accessory pathway
Risks	Caffeine, alcohol, stress, smoking, hyperthyroidism
Diagnosis	Electrocardiogram (ECG), Holter monitor
Differential diagnosis	Atrial fibrillation, atrial flutter, ventricular tachycardia
Prevention	N/A
Treatment	Vagal maneuvers, adenosine, beta blockers, calcium channel blockers, catheter ablation
Medication	N/A
Prognosis	Generally good with treatment
Frequency	Common
Deaths	N/A

Paroxysmal Supraventricular Tachycardia (PSVT)

An electrocardiogram (ECG) showing a typical pattern of PSVT.

Paroxysmal Supraventricular Tachycardia (PSVT) is a specific subtype of supraventricular tachycardia, distinguished by its episodic nature. Episodes can start and stop suddenly, often with varying durations and frequencies. Although many individuals with PSVT remain asymptomatic, the condition can lead to several symptoms that affect daily life.

Introduction

PSVT is a rapid heart rate originating from above the heart's ventricles. While "paroxysmal" refers to its sudden onset and termination, "supraventricular" points to its origin above the ventricles.

Symptoms

Many people with PSVT may not experience noticeable symptoms. However, when symptoms manifest, they can include:

• Palpitations: A sensation of a rapid, fluttering, or pounding heart.
• Lightheadedness or Dizziness: Due to altered blood flow during episodes.
• Sweating: Without any obvious reasons like heat or physical exertion.
• Shortness of Breath: Feeling unable to take a deep breath or gasping for air.
• Chest Pain: This can sometimes be severe and mistaken for a heart attack.

An individual experiencing chest pain, a potential symptom of PSVT.

Causes and Triggers

The exact cause of PSVT remains elusive, but potential triggers can include:

• Stress or anxiety
• Caffeine or alcohol consumption
• Certain medications
• Smoking
• Illicit drug use, such as cocaine

Diagnosis

Diagnosing PSVT involves several methods:

• Clinical History: Evaluating symptoms and their patterns.
• Physical Examination: Assessing heart rate and rhythm.
• Electrocardiogram (ECG): A test that measures the electrical activity of the heart.
• Holter Monitor: A wearable ECG device that continuously monitors heart rhythms over 24-48 hours.
• Event Monitor: Another wearable device, but used over weeks to months, activated when symptoms are felt.

Treatment

Treatment options for PSVT include:

• Vagal Maneuvers: Techniques such as coughing or bearing down, which can slow the heart rate.
• Medications: Drugs to control heart rate or prevent episodes.
• Cardioversion: An electrical shock to restore normal heart rhythm.
• Catheter Ablation: A procedure where problematic heart tissue causing the abnormal rhythm is destroyed.

Illustration of a catheter ablation procedure being performed.

Conclusion

Paroxysmal Supraventricular Tachycardia, while non-life-threatening in most cases, can lead to discomfort and anxiety. Recognizing its symptoms and understanding its management can help those affected lead normal and symptom-free lives.

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