Sun31October0735PM 9
Is it true or false that the following features are suggestive of supra-ventricular tachycardia (SVT) rather than sinus tachycardia?
True / False
A heart rate of 208 per minute Correct
The heart rate decreasing with a synchronised DC shock Correct
Cardioversion with a valsalva manoeuvre Correct
May be associated with a ventricular septal defect Correct
Presence of beat to beat variation Correct
Explanation
A variable R-R with a constant P-R interval occurs in sinus tachycardia.
A heart rate of greater than 160/min is suggestive of an SVT, and greater than 200/min is suggestive of an accessory pathway.
Carotid sinus massage and other vagal manoeuvres may assist in decreasing the heart rate and terminating an SVT.
Synchronised DC cardioversion is also effective at restoring the rate and rhythm in an emergency situation.
SVT is associated with congenital heart disease (CHD) and accessory pathway pathology:
Simple complexity - ASD/VSD/Valve disease
Moderate complexity - Fallots/Ebstein's abnormality
Great complexity-Fontan/Mustard/Total Cavopulmonary
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Times answered: 276