Paroxysmal supraventricular tachycardia (PSVT) is episodes of rapid heart rate that start in a part of the heart above the ventricles. "Paroxysmal" means from time to time.
Normally, the chambers of the heart (atria and ventricles) contract in a coordinated manner.
The rapid heart rate from PSVT may start with events that take place in many different areas above the lower heart chambers (ventricles).
The condition occurs most often in young people and infants.
The following increase your risk for PSVT:
Symptoms usually start and stop suddenly, and can last for a few minutes or several hours. They can include:
Other symptoms that can occur with this condition:
A physical examination during a PSVT episode will show a rapid heart rate. It may also show bounding pulses in the neck.
The heart rate may be over 100, and even more than 250 beats per minute (bpm). In children, the heart rate tends to be very high. There may be signs of poor blood circulation such as light-headedness. Between episodes of PSVT, the heart rate is normal (60 to 100 bpm).
Because PSVT comes and goes, to diagnose it patients may need to wear a 24-hour Holter monitor. For longer periods of time, another tape of the rhythm recording device may be used.
If you do not have symptoms or any other heart condition, PSVT may not need treatment.
If you have an episode of PSVT, there are techniques you can try on your own to interrupt the fast heartbeat.
You should avoid smoking, caffeine, alcohol, and illicit drugs.
Emergency treatment to slow the heartbeat back to normal may include:
Long-term treatment for people who have repeat episodes of PSVT, or who also have heart disease, may include:
PSVT is generally not life threatening. If other heart disorders are present, it can lead to congestive heart failure or angina.
Call your health care provider if:
PSVT; Supraventricular tachycardia
Olgin JE, Zipes DP. Specific arrhythmias: diagnosis and treatment. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. St. Louis, Mo: WB Saunders; 2011:chap 39.
Zimetbaum P. Cardiac arrhythmia with supraventricular origin. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 64.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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