Paroxysmal Supraventricular Tachycardia – Causes, Symptoms, Diagnosis, And Treatment
What is paroxysmal supraventricular tachycardia?
Paroxysmal supraventricular tachycardia (PSVT) is episodes of rapid heart rate that start above two lower chambers (ventricles) of the heart. Paroxysmal means from time to time. This condition develops when the normal electrical signals of the heart are disrupted.
What causes paroxysmal supraventricular tachycardia?
Abnormal conduction of electrical signals primarily in the atrium and secondarily in the ventricles causes the heart to beat very rapidly. This is referred to as paroxysmal because the rapid heart rate can occur episodically and may stop on its own.
There are a number of other specific factors that can cause PSVT. It can begin when doses of the digitalis, a heart medicine, are too high. PSVT can also be caused due to Wolff-Parkinson-White syndrome, which runs in families.
The following factors can increase the risk for PSVT:
- Caffeine use
- Alcohol use
- Illicit drug use
What are the symptoms of paroxysmal supraventricular tachycardia?
Most often symptoms can start and stop suddenly, but hey can last for a few minutes to several hours. The following are the common symptoms:
- Palpitations (a feeling or sensation that your heart is pounding or racing)
- Rapid pulse
- Chest tightness
- Shortness of breath
How is paroxysmal supraventricular tachycardia diagnosed?
The doctor will perform a physical exam and review your symptoms. If the physical exam is performed during an episode of a PSVT, it will show a rapid heart rate and forceful pulses in the neck.The heart rate can be over 100and even more than 250 beats per minute (bpm). The heart rate is usually normal between the episodes. The heart rate tends to be very high in children. There can be signs of poor blood circulation such as lightheadedness.
The doctor will do an ECG during symptoms, which may show PSVT. An electrophysiology study (EPS) may also be ordered for an accurate diagnosis.
As PSVT comes and goes, the doctor may recommend wearing a 24-hour Holter monitor or other device to record heart rhythms.
How is paroxysmal supraventricular tachycardia treated?
Treatment may not be needed if PSVT occurs only once in a while and if you don’t have symptoms or other heart problems.
The doctor may recommend the following techniques to help interrupt a fast heartbeat during an episode of PSVT:
- Valsalva maneuver. This involves holding your breath and strain as if you were trying to have a bowel movement.
- Coughing while sitting with your upper body bent forward.
- Splashing ice water on your face
The doctor may treat an affected person emergently to slow down and bring back the heartbeat back to normal with:
- Electrical cardioversion (electric shock to heart)
- Intravenous medicines
The doctor may recommend the following long-term treatment for people with repeat episodes of PSVT, who also have heart disease:
- Cardiac ablation to destroy small areas of your heart that may be causing the rapid heartbeat (currently the treatment of choice for most PSVTs)
- Daily medicines to prevent repeat episodes
- Pacemakers to override the fast heartbeat
- Surgery to change the pathways in the heart that send electrical signals
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.