Ventricular tachycardia history and symptoms: Difference between revisions

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{{Ventricular tachycardia}}
{{Ventricular tachycardia}}
{{CMG}}; '''Associate Editor-in Chief''': [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]
{{CMG}}; '''Associate Editor-in Chief''': {{Sara.Zand}} [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]
==Overview==
==Overview==
The symptoms of ventricular tachycardia will depend on the ventricular rate, the duration of [[tachycardia]], and the presence of underlying disease. In general, the symptoms include [[shortness of breath]], [[weakness]], [[palpitations]], [[fatigue]], and [[syncope]].
The [[symptoms]] of [[ventricular tachycardia]] will depend on the [[ventricular ]] rate, the duration of [[tachycardia]], and the presence of underlying disease. In general, the symptoms include [[palpitations]], [[lightheadedness]], [[syncope]], [[dyspnea]], [[chest pain]], [[cardiac arrest]]. Symptoms related to underlying [[heart disease]] include [[dyspnea]] at rest or on exertion, [[orthopnea]], [[paroxysmal nocturnal dyspnea]], [[chest pain]], [[edema]]. Precipitating factors maybe [[exercise]], or [[emotional stress]].
In [[patient]] presented with [[VT]] [[clinical history]] should be taken about [[coronary heart disease]], [[valvular heart disease]] ([[mitral valve prolapse]]), [[congenital heart disease]], [[thyroid disease]], [[acute kidney injury]], [[Chronic kidney disease]], [[electrolyte abnormalities]], [[stroke]], [[embolic events]], [[lung disease]],[[epilepsy]] ([[arrhythmic syncope]] can be misdiagnosed as [[epilepsy]]), [[alcohol]], [[illicit drug]] use, and use of over-the-counter medications causing [[QT prolongation]] and [[torsades de pointed]]. It is important to notify about the [[family history]] of [[SCD]] in first degree relatives, repetitive spontaneous [[pregnancy losses]] (concerning [[cardiac channelopathy]]), [[IHD]], [[hypertrophic cardiomyopathy ]], [[ dilated cardiomyopathy]], [[ARVC]], [[congenital heart disease]], [[cardiac channelopathies]]( [[Long QT]], [[Brugada]], [[Short QT]], [[CPVT]]), [[conduction disorders]], [[ pacemakers]]/[[ICDs]], and [[Neuromuscular disease]] associated with [[cardiomyopathies]] ([[Muscular dystrophy]], [[epilepsy]]).


==History and Symptoms==
== History ==
* Symptoms depend on:
* For [[patents]] presenting with [[VT]], history of underlying [[heart]] disease, other [[comorbidities]], [[medications]], and [[family history]] of [[SCD]] in first relative should be taken.
** Ventricular rate
Bellow table shown clinical [[history ]] related to [[VT]]:
** Duration of [[tachycardia]]
{| style="border: 2px solid #4479BA; align="left"
** Presence and extent of the underlying [[heart disease]] and [[peripheral vascular disease]].
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Components}}
! style="width: 300px; background: #4479BA;" | {{fontcolor|#FFF|Assessment and findings}}
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Symptoms
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |
* Symptoms related to [[arrhythmia]]<ref name="ZimetbaumJosephson1998">{{cite journal|last1=Zimetbaum|first1=Peter|last2=Josephson|first2=Mark E.|title=Evaluation of Patients with Palpitations|journal=New England Journal of Medicine|volume=338|issue=19|year=1998|pages=1369–1373|issn=0028-4793|doi=10.1056/NEJM199805073381907}}</ref><ref name="NodaShimizu2005">{{cite journal|last1=Noda|first1=Takashi|last2=Shimizu|first2=Wataru|last3=Taguchi|first3=Atsushi|last4=Aiba|first4=Takeshi|last5=Satomi|first5=Kazuhiro|last6=Suyama|first6=Kazuhiro|last7=Kurita|first7=Takashi|last8=Aihara|first8=Naohiko|last9=Kamakura|first9=Shiro|title=Malignant Entity of Idiopathic Ventricular Fibrillation and Polymorphic Ventricular Tachycardia Initiated by Premature Extrasystoles Originating From the Right Ventricular Outflow Tract|journal=Journal of the American College of Cardiology|volume=46|issue=7|year=2005|pages=1288–1294|issn=07351097|doi=10.1016/j.jacc.2005.05.077}}</ref>


*Symptoms generally consist of:
: [[Palpitations]], [[lightheadedness]], [[syncope]], [[dyspnea]], [[chest pain]], [[cardiac arrest]]
** [[Palpitations]]
* Symptoms related to underlying [[heart disease]]: [[Dyspnea]] at rest or on exertion, [[orthopnea]], [[paroxysmal nocturnal dyspnea]], [[chest pain]], [[edema]]
** [[Weakness]]
* Precipitating factors: [[Exercise]], [[emotional stress]]
** [[Fatigue]]
|-
** [[Chest pain]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Past medical history
** [[Shortness of breath]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |
** [[Light-headedness]] ([[dizziness]])
* [[Heart disease]]: [[Coronary]], [[valvular]] ([[mitral valve prolapse]]), [[congenital heart disease]]
** [[Syncope]]
* [[Thyroid disease]]
** Neck fullness due to [[jugular venous distension]].
* [[Acute kidney injury]]
* [[Chronic kidney disease]]
* [[Electrolyte abnormalities]]
* [[Stroke]],[[embolic events]]
* [[Lung disease]]
* [[Epilepsy]] ([[arrhythmic syncope]] can be misdiagnosed as [[epilepsy]])
* [[ Alcohol]], [[illicit drug]] use
* Use of over-the-counter medications caused [[QT prolongation]] and [[torsades de pointes]]
* [[ Unexplained motor vehicle accident]]
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Medications
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |
* [[Antiarrhythmic]] medications
* Medication with  QT prolongation and torsades de pointes effect
* [[Cocaine]],[[amphetamines]]
* [[Anabolic steroids]]
* Medication-medication interaction that could cause [[QT prolongation]] and [[torsades de pointes]]
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Family history
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |
* [[SCD]], [[SCA]], [[unexplained drowning]] in a first-degree relative
* [[SIDS]], repetitive spontaneous [[pregnancy losses]] concerning [[cardiac channelopathies]]
* [[IHD]]
* [[Cardiomyopathy]]: [[Hypertrophic]],[[ dilated]], [[ARVC]]
* [[Congenital heart disease]]
* [[ Cardiac channelopathies]]: [[Long QT]], [[Brugada]], [[Short QT]], [[CPVT]]
* [[Arrhythmias]]: [[conduction disorders]], [[ pacemakers]]/[[ICDs]]
* [[Neuromuscular disease]] associated with [[cardiomyopathies]]
* [[Muscular dystrophy]]
* [[Epilepsy]]
|-
 
|}
 
==Symptoms==
* [[Ventricular tachycardia]] can be symptomatic or asymptomatic.
 
*Common [[symptoms]] of [[ventricular tachycardia]] include:<ref name="pmid19252119">{{cite journal |vauthors=Koplan BA, Stevenson WG |title=Ventricular tachycardia and sudden cardiac death |journal=Mayo Clin. Proc. |volume=84 |issue=3 |pages=289–97 |date=March 2009 |pmid=19252119 |pmc=2664600 |doi=10.1016/S0025-6196(11)61149-X |url=}}</ref><ref name="pmid3993009">{{cite journal |vauthors=Morady F, Shen EN, Bhandari A, Schwartz AB, Scheinman MM |title=Clinical symptoms in patients with sustained ventricular tachycardia |journal=West. J. Med. |volume=142 |issue=3 |pages=341–4 |date=March 1985 |pmid=3993009 |pmc=1306023 |doi= |url=}}</ref>
**[[Palpitations]]
**[[Weakness]]
**[[Fatigue]]
**[[Chest pain]]
**[[Shortness of breath]]
**[[Light-headedness]] ([[dizziness]])
**[[Syncope]], [[presyncope]]
** Neck fullness due to [[jugular venous distension]]
** [[Cardiac arrest]]


==References==
==References==

Latest revision as of 03:37, 31 May 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in Chief: Sara Zand, M.D.[2] Avirup Guha, M.B.B.S.[3]

Overview

The symptoms of ventricular tachycardia will depend on the ventricular rate, the duration of tachycardia, and the presence of underlying disease. In general, the symptoms include palpitations, lightheadedness, syncope, dyspnea, chest pain, cardiac arrest. Symptoms related to underlying heart disease include dyspnea at rest or on exertion, orthopnea, paroxysmal nocturnal dyspnea, chest pain, edema. Precipitating factors maybe exercise, or emotional stress. In patient presented with VT clinical history should be taken about coronary heart disease, valvular heart disease (mitral valve prolapse), congenital heart disease, thyroid disease, acute kidney injury, Chronic kidney disease, electrolyte abnormalities, stroke, embolic events, lung disease,epilepsy (arrhythmic syncope can be misdiagnosed as epilepsy), alcohol, illicit drug use, and use of over-the-counter medications causing QT prolongation and torsades de pointed. It is important to notify about the family history of SCD in first degree relatives, repetitive spontaneous pregnancy losses (concerning cardiac channelopathy), IHD, hypertrophic cardiomyopathy , dilated cardiomyopathy, ARVC, congenital heart disease, cardiac channelopathies( Long QT, Brugada, Short QT, CPVT), conduction disorders, pacemakers/ICDs, and Neuromuscular disease associated with cardiomyopathies (Muscular dystrophy, epilepsy).

History

Bellow table shown clinical history related to VT:

Components Assessment and findings
Symptoms
Palpitations, lightheadedness, syncope, dyspnea, chest pain, cardiac arrest
Past medical history
Medications
Family history

Symptoms

References

  1. ↑ Zimetbaum, Peter; Josephson, Mark E. (1998). "Evaluation of Patients with Palpitations". New England Journal of Medicine. 338 (19): 1369–1373. doi:10.1056/NEJM199805073381907. ISSN 0028-4793.
  2. ↑ Noda, Takashi; Shimizu, Wataru; Taguchi, Atsushi; Aiba, Takeshi; Satomi, Kazuhiro; Suyama, Kazuhiro; Kurita, Takashi; Aihara, Naohiko; Kamakura, Shiro (2005). "Malignant Entity of Idiopathic Ventricular Fibrillation and Polymorphic Ventricular Tachycardia Initiated by Premature Extrasystoles Originating From the Right Ventricular Outflow Tract". Journal of the American College of Cardiology. 46 (7): 1288–1294. doi:10.1016/j.jacc.2005.05.077. ISSN 0735-1097.
  3. ↑ Koplan BA, Stevenson WG (March 2009). "Ventricular tachycardia and sudden cardiac death". Mayo Clin. Proc. 84 (3): 289–97. doi:10.1016/S0025-6196(11)61149-X. PMC 2664600. PMID 19252119.
  4. ↑ Morady F, Shen EN, Bhandari A, Schwartz AB, Scheinman MM (March 1985). "Clinical symptoms in patients with sustained ventricular tachycardia". West. J. Med. 142 (3): 341–4. PMC 1306023. PMID 3993009.

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