From the Guidelines
Paroxysmal supraventricular tachycardia (PSVT) typically presents as a sudden onset of rapid, regular heart rate, usually between 150-250 beats per minute, with symptoms including palpitations, chest discomfort, shortness of breath, lightheadedness, anxiety, and occasionally syncope. The presentation of PSVT is characterized by a clinical syndrome with a regular and rapid tachycardia of abrupt onset and termination, as defined in the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia 1.
Key Features of PSVT
- Sudden onset and termination of symptoms
- Regular and rapid heart rate, usually between 150-250 beats per minute
- Symptoms include:
- Palpitations
- Chest discomfort
- Shortness of breath
- Lightheadedness
- Anxiety
- Occasional syncope The ECG characteristics of PSVT include a narrow-complex tachycardia with absent P waves or P waves that are hidden within the preceding T wave, and a regular R-R interval, as described in the guideline 1.
ECG Characteristics of PSVT
- Narrow-complex tachycardia
- Absent P waves or P waves hidden within the preceding T wave
- Regular R-R interval The diagnosis of PSVT is often made based on a combination of clinical history, physical examination, and ECG findings, as outlined in the ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias 1.
Diagnosis of PSVT
- Clinical history: sudden onset and termination of symptoms, regular and rapid heart rate
- Physical examination: regular tachycardia with normal blood pressure, though hypotension can occur in severe cases
- ECG findings: narrow-complex tachycardia with absent P waves or P waves hidden within the preceding T wave, and a regular R-R interval Overall, the presentation of PSVT is characterized by a sudden onset of rapid, regular heart rate, with symptoms and ECG findings that are consistent with a reentry circuit involving the AV node or an accessory pathway.
From the Research
Presentation of Paroxysmal Supraventricular Tachycardia (PSVT)
The presentation of PSVT can be identified through various symptoms and diagnostic methods, including:
- Palpitations (86%) 2
- Chest discomfort (47%) 2
- Dyspnea (38%) 2
- Dizziness 3
- Electrocardiogram (ECG) showing a narrow QRS complex and regular tachycardia with hidden or inverted P waves 3
- ECG during an arrhythmic event or using ambulatory monitoring 2
Demographics
PSVT affects:
- 168 to 332 per 100 000 individuals 2
- Approximately 50% of patients are aged 45 to 64 years 2
- 67.5% of patients are female 2
Potential Complications
Untreated PSVT is associated with adverse outcomes, including: