Supraventricular Tachyarrhythmia

Question 1

SVT define

Answer 1

A dysarrhythmja originating at or above the AV node & is defined by a narrow complex (QRS < 120 ms) and at a rate > 100 bpm

Question 2

Causes of SVT

Answer 2

Atrium problems

1. Inappropriate sinus tachycardia
2. Focal atrial tachycardia
3. Atrial flutter
4. Atrial fibrillation
5. Multi focal atrial tachycardia

AV nodal eee try tachycardia

Associated with accessory AV pathways
1. Orthodontic AV recently tachycardia
2. Pre excited tachycardia

Question 3

Clinical presentation in SVT

Answer 3

Palpitations
Chest pain
Syncope
Dyspnea
Cardiac arrest
Emboli sequale

Question 4

Investigations & evaluations in SVT

Answer 4

bloods
FBC
electrolytes
TFT
Cardiac enzymes if pain+
Digoxin levels if pt is on digoxin

ECG

24 he ambulatory monitoring

CXR - signs of HF?
Echo - TOE - mural thrombi?
Stress test
Coronary angiogram
Electrophysiological studies

Question 5

Management of SVT

Answer 5

1. ABCDE , oxygen if hypoxic
2. Continuous ECG monitoring

non pharmacist Mx
- Valsalva manuevre
- carotid massage

• pharmacological
• large grey cannula
• ADENOSINE rapid bolus 06mg, 12mg , 12mg

If adenosine is contraInx - Verapamil

Maybe followed by Amidarone

If unstable ,
Synchronized cardio version