Supraventricular Tachycardia
Basics
Description
Description
- Rhythm that originates ectopically above the His bundle
- Heart rate of 100 bpm or greater
- Irregular narrow complex supraventricular tachycardia (SVT):
- Atrial fibrillation (AF):
- Most common form of pathologic SVT seen in the ED
- 10% of people >75 yr of age with AF
- Atrial flutter with variable block
- Multifocal atrial tachycardia
- Atrial fibrillation (AF):
- Regular narrow complex SVT:
- Atrial flutter
- Atrioventricular nodal re-entry tachycardia (AVNRT):
- 60% of SVT in adults, 70% are female
- Typically present age 30–40 yr
- Atrioventricular reciprocating tachycardia (AVRT) involving an accessory pathway
- Wide complex SVT:
- Conduction is outside of the normal His–Purkinje system
- Accessory pathway or a bundle branch block is present
- More common in younger patients without structural disease
- Always suspect a ventricular rhythm with a wide complex rhythm
- Treat as ventricular tachycardia (VT) unless absolutely certain of SVT
Etiology
Etiology
- Sinus tachycardia:
- Acute MI
- Anemia
- Anxiety
- CHF
- Drug intoxication
- Hyperthyroidism
- Hypovolemia
- Hypoxia
- Infection
- Pain
- Pericardial tamponade
- Pulmonary embolism
- Atrial tachycardia:
- Electrolyte disturbances
- Drug toxicity (e.g., theophylline)
- Hypoxia
- Junctional tachycardia:
- AV nodal re-entry
- Myocardial ischemia
- Structural heart disease
- Pre-excitation syndromes
- Wolff–Parkinson–White (WPW) syndrome:
- Intrinsic accessory pathway
- Drug and alcohol toxicity
- Atrial fibrillation:
- HTN
- Coronary artery disease
- Hyper/hypothyroidism
- Alcohol intake
- Mitral valve disease
- Chronic obstructive pulmonary disease
- Pulmonary embolism
- Hypoxia
- Digoxin toxicity
- Chronic pericarditis
- Idiopathic AF
- Atrial flutter:
- Ischemic heart disease
- Valvular heart diseases
- CHF
- Myocarditis
- Cardiomyopathies
- Pulmonary embolism
- Electrolyte abnormalities
- Multifocal atrial tachycardia:
- Hypoxic effects of chronic lung disease
- Theophylline toxicity
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Citation
Schaider, Jeffrey J., et al., editors. "Supraventricular Tachycardia." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/0.1/Supraventricular_Tachycardia.
Supraventricular Tachycardia. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/0.1/Supraventricular_Tachycardia. Accessed December 3, 2024.
Supraventricular Tachycardia. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/0.1/Supraventricular_Tachycardia
Supraventricular Tachycardia [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 03]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/0.1/Supraventricular_Tachycardia.
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