Supraventricular tachycardia

Presented by normadihah binti mohd zainuddin bolek

Definition Normal Conduction of the heart Signs & symptoms Management

 Svt is a rapid but regular heart beat rate ( 160200 bpm ) that originates in the atria . Narrow QRS complex will be shown in the ECG

Normal conduction of the heart

Begins at sa node Av node av bundle ( bundle of his ) enter both the rt and lt bundle branches purkinje fibers ; - ventricles contract ,pushing blood upward toward the semilunar valves.

Manifestations
Patient complaint of palpitations Racing heart Anxiety Dizziness Dyspnea Anginal pain Diaphoresis Extreme fatigue Polyuria( urine output may reach up to 3L in the first few hours after onset )

Management
I. Acute therapy 1. Immediate synchronized cardioversion starting at 50J can be used immediately in pt who are hypotensivee ,have pulmonary oedema ,have chest pain with ischemia or unstable.

2. Drugs a. Adenosine : Rapid (in 1-2s) IV bolus 6 mg ,followed by a 20 ml normal saline flush . Onset of action is 15-30s and duration of action lasts only 1-2 min.A second bolus injection of 12 mg is repeated 2-5 min after the first if the arrythymia persist or recurs.Another 12 mg dose may be given in 2-5 min, if required. Adenosine should be avoided in patients with known or suspected bronchoconstrictive disease.

 Diagnostic tests include - ECG - cardiac monitoring - electrophysiology studies -lab tests such as serum electrolytes,drug levels & ABGs

 Countershock ,2 types : - synchonized cardioversion Deliver direct electrical current synchronized with the patients heart rhythm. -defibrillation

 Pacemaker therapy Other therapies for such vagal maneuvers. -These include carotid sinus massage and vasalva maneuver