SVT

Question 1

define SVT?

Answer 1

a regular narrow-complex tachycardia (> 100 bpm) with no p waves and a supraventricular origin.

Question 2

what are the common types of SVT?

Answer 2

• Atrioventricular Nodal Re-entry Tachycardia (AVNRT)

* Atrioventricular Re-entry Tachycardia (AVRT)

Question 3

risk factors?

Answer 3

o	Nicotine  
o	Alcohol  
o	Caffeine  
o	Previous MI  
o	Digoxin toxicity

Question 4

epidemiology?

Answer 4

common esp in females

Question 5

presenting symptoms of SVT?

Answer 5

• Syncope
• Palpitations
• Light-headedness

Question 6

signs of AVNRT?

Answer 6

normal except tachycardia

Question 7

signs of AVRT?

Answer 7

o Tachycardia

S3 gallop, RV heave, displaced apex beat

Question 8

investigations for SVT?

Answer 8

• ECG
to differentiate between the two
• AVNRT - appears normal
• AVRT - delta-waves (slurred upstroke of the QRS complex)

Question 9

how to manage SVT if unstable?

Answer 9

o DC cardioversion

Question 10

how to manage SVT if stable?

Answer 10

o Vagal manoeuvres = valsalva and carotid massage
o if these fail then IV adenosine: 6mg -> 12mg -> 12mg
o if this fails o Sedate and synchronised DC cardioversion and Amiodarone

Question 11

ongoing management of AVNRT?

Answer 11

• Radiofrequency ablation of slow pathway

* Beta-blockers

Question 12

ongoing management of AVRT?

Answer 12

• Radiofrequency ablation

Question 13

when do you not do a carotid massage?

Answer 13

if the patient is old due to risk of plaques