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Supraventricular Tachycardia, Emergency Medicine

Reviewed 06/2017
 


Basics

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 commo...

Diagnosis

Signs and Symptoms

  • Palpitations (most common)

  • Lightheadedness, pressure in the head

  • Dyspnea

  • Diaphoresis

  • Dizziness

  • Weakness

  • Chest discomfort

  • Syncope

  • Prominent neck veins “frog sign”

  • Signs of instabilit...

Treatment

Pre-Hospital

  • Supplemental oxygen

  • IV access

  • Monitor

Initial Stabilization/Therapy

  • IV access

  • Oxygen

  • Monitor

Ed Treatment/Procedures

  • AF/atrial flutter:

    • AF is most likely diagnosed when the rhythm is irre...

Follow-Up

Disposition

Admission Criteria

  • Possible cardiac ischemic event

  • Persistent SVT

  • Possible pre-excitation syndrome

  • Other underlying metabolic abnormalities

Discharge Criteria

Terminated rhythm without ...

Pearls and Pitfalls

  • Valsalva maneuvers should, ideally, be attempted with the patient lying flat. Despite the modest likelihood of success, the maneuver is simple and efficient.

  • AF is the most worrisom...

Additional Reading

  • Colucci  RA, Silver  MJ, Shubrook  J. Common types of supraventricular tachycardia: Diagnosis and management. Am Fam Physician.  2010;82(8):942–952.

  • Hood  RE, Shorofsky  SR. Man...

Codes

ICD9

  • 427.0 Paroxysmal supraventricular tachycardia

  • 427.89 Other specified cardiac dysrhythmias

ICD10

I47.1 Supraventricular tachycardia 

SNOMED

  • 6456007 Supraventricular tachycardia (disorder)

  • 67198005 ...

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