http://www.fpnotebook.com/
Narrow Complex Tachycardia
Aka: Narrow Complex Tachycardia, Supraventricular Tachycardia, Paroxysmal Supraventricular Tachycardia, PSVT
- See Also
- Unstable Tachycardia
- Sinus Tachycardia
- Atrial Fibrillation
- Wide Complex Tachycardia
- Cardiopulmonary Resuscitation
- Causes: Narrow Complex Tachycardia (Mnemonic: 4H 4T P)
- Similar list to Reversible Causes of Cardiopulmonary Arrest (5H5T)
- Hypoxemia
- Hypovolemia
- Hyperthermia
- Hyperkalemia or Hypokalemia
- Tamponade (Cardiac Tamponade)
- Tension Pneumothorax
- Toxins, medications and drugs
- Caffeine
- Tobacco
- Alcohol
- Pseudophedrine
- Thromboembolism (e.g. Myocardial Infarction or Pulmonary Embolism)
- Pain or Stress
- Types: Narrow Complex Tachycardia (key question is 'regular or irregular')
- Sinus Tachycardia (regular)
- Irregular Supraventricular Tachycardia (may also present as wide complex if aberrancy)
- Atrial Fibrillation
- Regular Supraventricular Tachycardia
- Atrial Flutter
- Atrioventricular Nodal Reentry (AVNRT): 60% of SVT cases
- Atrioventricular Reciprocating Tachycardia (AVRT): 30% of SVT cases
- Atrial Tachycardia (AT): 10% of SVT cases
- Symptoms
- Chest pressure
- Dyspnea
- Fatigue
- Light headed
- Palpitations
- Signs
- Sinus Tachycardia
- P Waves present and normal
- Variable R-R with constant PR interval
- Rate lower than PSVT
- Infants < 220
- Children < 180
- Adults < 160
- Supraventricular Tachycardia
- P Waves absent or abnormal
- Abrupt rate change
- Rate higher than Sinus Tachycardia
- Infants > 220
- Children > 180
- Adults > 160
- Management: Stable Patients
- New emphasis on use of one Antiarrhythmic
- Contrast to prior Antiarrhythmic soups
- Pro-arrhythmic effects increase with poly-drugs
- Supraventricular Tachycardia Management in the Adult
- Supraventricular Tachycardia Management in the Child
- Management: Unstable Patients
- See Unstable Tachycardia
- References
- Hebbar (2002) Am Fam Physician 65(12):2479-86
- Cardiopulmonary Resuscitation Guidelines
- http://www.circulationaha.org
- (2010) Guidelines for CPR and ECC
- (2005) Circulation 112(Suppl 112):IV
- (2000) Circulation, 102(Suppl I):86-9