Supraventricular Tachycardia

By behereaxum

Summary

Your patient suddenly clutches their chest, heart pounding, dizzy, out of nowhere. This is supraventricular tachycardia, or SVT.

Chapters

  1. Your patient suddenly clutches their chest, (0s)
  2. SVT begins above the ventricles, in (8s)
  3. On the ECG, look for a (19s)
  4. First, try vagal maneuvers, have the (29s)
  5. If that fails, give adenosine, six (34s)
  6. For patients with recurring episodes, catheter (49s)
  7. Recognize it, treat it in steps, (57s)

Transcript

Your patient suddenly clutches their chest, heart pounding, dizzy, out of nowhere. This is supraventricular tachycardia, or SVT. SVT begins above the ventricles, in the atria or the A-V node, where an electrical loop fires over and over, driving the heart rate past 150 beats per minute. On the ECG, look for a fast, regular rhythm with narrow QRS complexes. The P waves are often buried inside the preceding T wave, so they seem to disappear. First, try vagal maneuvers, have the patient bear down or apply an ice pack to the face. If that fails, give adenosine, six milligrams by rapid IV push, followed immediately by a saline flush. If it doesn't work, repeat with twelve. Expect a brief pause before the rhythm resets, and warn the patient it may feel strange. For patients with recurring episodes, catheter ablation threads a thin wire to the heart and destroys the faulty pathway, offering a lasting fix. Recognize it, treat it in steps, and your patient's heart finds its rhythm again.