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Narrow Complex TachycardiaAka: Supraventricular Tachycardia, Multifocal Atrial Tachycardia, Paroxysmal Supraventricular Tachycardia, PSVT

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  1. See Also
    1. Guidelines 2000 CPR and Emergency Cardiovascular Care
    2. Unstable Tachycardia
    3. Sinus Tachycardia
    4. Atrial Fibrillation
    5. Wide Complex Tachycardia
  2. Causes (Mnemonic: 4H 4T P)
    1. Hypoxemia
    2. Hypovolemia
    3. Hyperthermia
    4. Hyperkalemia or Hypokalemia
    5. Tamponade (Cardiac Tamponade)
    6. Tension Pneumothorax
    7. Toxins, medications and drugs
      1. Caffeine
      2. Tobacco
      3. Alcohol
      4. Pseudophedrine
    8. Thromboembolism
    9. Pain or Stress
  3. Types: Narrow complex tachycardia
    1. Sinus Tachycardia
    2. Supraventricular Tachycardia
      1. Atrial Fibrillation (irregular)
      2. Atrial flutter (regular)
      3. Paroxysmal Supraventricular tachycardia (regular)
        1. Atrioventricular nodal reentry (most common)
          1. Starts with PAC passed down slow accesory path
          2. Signal travels retrograde up fast path
          3. Signal cycles back down slow accesory pathway
          4. Heart Rate of 160 to 190 with no P Waves seen
        2. Accessory pathway (e.g. Wolff-Parkinson-White)
          1. Heart Rate 160 to 240
          2. Delta waves not seen (normal pathway used)
        3. Increased automaticity
          1. Results in multifocal atrial tachycardia
          2. Heart Rate 130 to 180
          3. Causes: enlarged atrium
            1. Chronic lung disease
            2. Congestive Heart Failure
          4. Causes: other
            1. Electrolyte abnormalities
            2. Acid-base disturbance
  4. Signs
    1. Sinus Tachycardia
      1. P Waves present and normal
      2. Variable R-R with constant PR interval
      3. Rate lower than PSVT
        1. Infants < 220
        2. Children < 180
        3. Adults < 160
    2. Supraventricular Tachycardia
      1. P Waves absent or abnormal
      2. Abrupt rate change
      3. Rate higher than Sinus Tachycardia
        1. Infants > 220
        2. Children > 180
        3. Adults > 160
  5. Management: Stable Patients
    1. New emphasis on use of one Antiarrhythmic
      1. Contrast to prior Antiarrhythmic soups
      2. Pro-arrhythmic effects increase with poly-drugs
    2. Supraventricular Tachycardia Management in the Adult
    3. Supraventricular Tachycardia Management in the Child
  6. Management: Unstable Patients
    1. See Unstable Tachycardia
  7. References
    1. Hebbar (2002) Am Fam Physician 65(12):2479
    2. (2000) Circulation, 102(Suppl I):86-9
    3. http://www.circulationaha.org

Paroxysmal supraventricular tachycardia (C0030590)

Definition (NCI)An episodic form of supraventricular tachycardia, with abrupt onset and termination.
ConceptsDisease or Syndrome (T047)
ICD9427.0
EnglishPAROX ATRIAL TACHYCARDIA, Paroxysmal sup. tachy., Paroxysmal supraventricular tachycardia, Supravent. tach. parox.
Spanishtaquicardia supraventricular paroxística, taquicardia supraventricular paroxistica
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Supraventricular tachycardia (C0039240)

Definition (MSH)A generic expression for any tachycardia that originates above the BUNDLE OF HIS.
ConceptsDisease or Syndrome (T047)
EnglishSupraventricular tachycardia, Supraventricular Tachycardias, SVT, TACHYCARDIA SUPRAVENTRICULAR
Spanishtaquicardia supraventricular
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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