Paroxysmal supraventricular tachycardia
| Paroxysmal supraventricular tachycardia | |
|---|---|
| Synonyms | supraventricular tachycardia, paroxysmal atrial tachycardia (PAT) |
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| Lead II electrocardiogram strip showing PSVT with a heart rate of about 180. | |
| Classification and external resources | |
| Specialty | Cardiology |
| ICD-10 | I47.1 |
| ICD-9-CM | 427.0 |
| MeSH | D013617 |
Paroxysmal supraventricular tachycardia (PSVT) is a type of supraventricular tachycardia. Often people have no symptoms. Otherwise symptoms may include palpitations, feeling lightheaded, sweating, shortness of breath, and chest pain. Episodes start and end suddenly.
The cause is not known. Risk factors include alcohol, caffeine, nicotine, psychological stress, and Wolff-Parkinson-White syndrome which often is inherited from a person's parents. The underlying mechanism typically involves an accessory pathway that results in re-entry. 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.
Vagal maneuvers, such as the valsalva maneuver, are often used as the initial treatment. If not effective and the person has a normal blood pressure the medication adenosine may be tried. If adenosine is not effective a calcium channel blockers or beta blocker maybe used. Otherwise synchronized cardioversion is the treatment. Future episodes can be prevented by catheter ablation.
About 2.3 per 1000 people have paroxysmal supraventricular tachycardia. Problems typically begin in those 12 to 45 years old. Women are more often affected than men. Outcomes in those who otherwise have a normal heart are generally good. An ultrasound of the heart may be done to rule out underlying heart problems.
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