Author: akanksha, Posted on Thursday, May 17 @ 02:09:14 IST by akanksha  

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A 18 yr old girl comes with sudden onset palpitations and light headedness. She describes the palpitations as a very fast heart rate and denies any chest pain or shortness of breath. Her ECG shows the following tracing. Most likely diagnosis is:

A. Atrial fibrillation

B. Ventricular Tachycardia

C. Supraventricular Tachycardia

D. Wolf-Parkinson-White Syndrome

Correct Answer: C. Supraventricular Tachycardia

A supraventricular tachycardia (SVT) is a type of tachyarrythmia in which the origin of the electrical signal is either the atria or the AV node.

The impulses arise from atria (above the ventricles), hence the term supraventricular.

Patients usually present with symptoms like:

• Palpitations

• Lightheadedness

• Dizziness

• Loss of consciousness

• Chest pain

• Shortness of breath

12 lead ECG is usually diagnostic.

Medications may be used to treat many patients with SVT. The most commonly used classes of medications are:

• ß-blockers: These are commonly used to treat high blood pressure and other heart problems such as angina. In SVT, they are used specifically to decrease conduction through the AV node to stop conduction during the tachycardia.

• Calcium channel blockers: These are also used to treat high blood pressure and heart problems. Like ß-blockers, they may be used to decrease conduction through the AV node. Examples of calcium channel blockers include verapamil or diltiazem.

• Antiarrhythmic agents: These agents are used to treat various arrhythmias and directly affect the atrial or ventricular heart tissue. They are most useful in SVTs that use an accessory pathway or bypass tract or in atrial tachycardias.

© 2007 onwards by Akanksha