Supraventricular Tachycardia

Question 1

What is the cause of Supraventricular Tachycardia? (3 steps)

Answer 1

1. Electrical signal re-enters atria from ventricles
2. Electrical signal goes thru AV node –> another ventricular contraction
3. Loop of more n more ventricular contractions

Question 2

What are the 3 types of SVT?

Answer 2

1. AtrioVentricular NODAL Re-entrant Tachycardia
2. AtrioVentricular Re-entrant Tachycardia
3. Atrial Tachycardia

Question 3

What is AtrioVentricular NODAL Re-entrant Tachycardia SVT?

Answer 3

When electrical signal re-enters via AV Node

Question 4

What is AtrioVentricular Re-entrant Tachycardia SVT?

Answer 4

When electrical signal re-enters via Accessory pathway (Wolff-Parkinson-White syndrome)

Question 5

What is Atrial Tachycardia SVT?

Answer 5

When there is ECTOPIC electrical signals (don’t originate in SA Node)

Question 6

What are the ECG changes seen in Supraventricular Tachycardia? (4 things)

Answer 6

1. Hidden P wave
2. Narrow QRS complex
3. Regular rhythm (unlike AF)
4. Tachycardia obv

Question 7

What are the clinical features of Supraventricular Tachycardia? (5 things)

Answer 7

1. SOB
2. Syncope
3. Sweating
4. Chest pain
5. Palpitations

Question 8

What are the management options for Supraventricular Tachycardia? (4 things) (in order)

Answer 8

1. Valsalva Manoeuvre
2. Carotid Sinus Massage
3. Adenosine (antiarrhythmic) / Verapamil (calcium channel blocker) (alternative to adenosine)
4. Cardioversion (if all above fails)

Question 9

What is the Valsalva Manoeuvre?

Answer 9

Ask pt to blow hard against resistance (e.g into plastic syringe)

Question 10

How does Adenosine work?

Answer 10

Interrupts AV node / accessory pathway –> resets heart bk to Normal Sinus Rhythm

Question 11

What is scary about Adenosine?

Answer 11

Causes a period of asystole / bradycardia (feeling of dying / impending doom)

Question 12

What are the CONTRAindications of Adenosine? (5 things)

Answer 12

1. Asthma / COPD
2. HF / Heart Block
3. Severe HTN

Question 13

What are the long term management options of Paroxysmal SVT (recurrent episodes)? (2 things)

Answer 13

1. Medication
2. Radiofrequency ablation

Question 14

What are the MEDICAL long term management options for Paroxysmal SVT (recurrent episodes)? (3 things)

Answer 14

1. Beta blockers
2. Calcium channel blockers
3. Amiodarone

Question 15

What is Radiofrequency ablation?

Answer 15

Burns / scars part of heart to stop electrical signals from passing thru it

Question 16

What type of SVT is Wolff-Parkinson White Syndrome?

Answer 16

AtrioVentricular Re-entrant Tachycardia SVT?

Question 17

What is the cause of Wolff-Parkinson White Syndrome?

Answer 17

An extra electrical pathway connecting atria + ventricles called Bundle of Kent

Question 18

What are the ECG changes seen in Wolff-Parkinson White Syndrome (SVT)? (3 things)

Answer 18

1. Short PR interval
2. Delta wave (curved upstroke on start of QRS complex instead of right angle)
3. Wide QRS complex

Question 19

What is the definitive treatment for Wolff-Parkinson White Syndrome?

Answer 19

Radiofrequency ablation of the accessory pathway (Bundle of Kent)