Pulseless ventricular tachycardia history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Pulseless ventricular tachycardia may be symptomatic or asymptomatic. In a young patient with a family history of sudden death, immediate evaluation for an inherited ventricular syndrome is recommended. If symptomatic, the ventricular rate, | Pulseless ventricular tachycardia may be symptomatic or asymptomatic. In a young patient with a family history of sudden death, immediate evaluation for an inherited ventricular syndrome is recommended. If symptomatic, the ventricular rate, duration of tachycardia, and the presence of underlying disease determine the kind of symptoms that present. | ||
===History=== | ===History=== | ||
In young patients with a positive family history of sudden death, evaluation for inherited arrhythmia syndromes is warranted.<ref name="pmid27484660">{{cite journal |vauthors=Baldzizhar A, Manuylova E, Marchenko R, Kryvalap Y, Carey MG |title=Ventricular Tachycardias: Characteristics and Management |journal=Crit Care Nurs Clin North Am |volume=28 |issue=3 |pages=317–29 |date=September 2016 |pmid=27484660 |doi=10.1016/j.cnc.2016.04.004 |url=}}</ref> Inherited arrhythmia disorders include: | |||
*[ | *[[Long QT syndrome|Congenital long QT]] (LQT)<ref name="pmid234667">{{cite journal |vauthors=Schwartz PJ, Periti M, Malliani A |title=The long Q-T syndrome |journal=Am. Heart J. |volume=89 |issue=3 |pages=378–90 |date=March 1975 |pmid=234667 |doi=10.1016/0002-8703(75)90089-7 |url=}}</ref> | ||
*[ | *[[Brugada syndrome]] (BrS)<ref name="pmid24568830">{{cite journal |vauthors=Chockalingam P, Wilde AA |title=Inherited arrhythmia syndromes leading to sudden cardiac death in the young: a global update and an Indian perspective |journal=Indian Heart J |volume=66 Suppl 1 |issue= |pages=S49–57 |date=2014 |pmid=24568830 |pmc=4237302 |doi=10.1016/j.ihj.2013.11.008 |url=}}</ref> | ||
*[ | *[[Hypertrophic cardiomyopathy]] | ||
*[[Arrhythmogenic right ventricular dysplasia]] (ARVD) | |||
*[[Short QT syndrome|Congenital short QT intervals]] (SQT)<ref name="pmid23994779">{{cite journal |vauthors=Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, Kannankeril P, Krahn A, Leenhardt A, Moss A, Schwartz PJ, Shimizu W, Tomaselli G, Tracy C, Ackerman M, Belhassen B, Estes NA, Fatkin D, Kalman J, Kaufman E, Kirchhof P, Schulze-Bahr E, Wolpert C, Vohra J, Refaat M, Etheridge SP, Campbell RM, Martin ET, Quek SC |title=Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes |journal=Europace |volume=15 |issue=10 |pages=1389–406 |date=October 2013 |pmid=23994779 |doi=10.1093/europace/eut272 |url=}}</ref> | |||
*[[Early repolarization syndrome]] | |||
*[[Ventricular fibrillation, idiopathic|Idiopathic ventricular fibrillation]] (IVF)<ref name="pmid2202193">{{cite journal |vauthors=Viskin S, Belhassen B |title=Idiopathic ventricular fibrillation |journal=Am. Heart J. |volume=120 |issue=3 |pages=661–71 |date=September 1990 |pmid=2202193 |doi=10.1016/0002-8703(90)90025-s |url=}}</ref> | |||
=== | === Symptoms=== | ||
*Pulseless ventricular tachycardia can be symptomatic or asymptomatic. | |||
*[ | *If symptomatic, the ventricular rate, duration of tachycardia, and the presence of underlying [[heart disease]] determine the kind of symptoms that present. | ||
*On initial presentation, patients with impending [[pulseless ventricular tachycardia]] may present with signs of inadequate [[cardiac perfusion]] such as <ref name="pmid21593723">{{cite journal |vauthors=Barsheshet A, Goldenberg I |title=Cardiovascular syncope: diagnostic approach and risk assessment |journal=Minerva Med. |volume=102 |issue=3 |pages=223–38 |date=June 2011 |pmid=21593723 |doi= |url=}}</ref> <ref name="pmid10532503">{{cite journal |vauthors=Moss AJ, Robinson JL, Gessman L, Gillespie R, Zareba W, Schwartz PJ, Vincent GM, Benhorin J, Heilbron EL, Towbin JA, Priori SG, Napolitano C, Zhang L, Medina A, Andrews ML, Timothy K |title=Comparison of clinical and genetic variables of cardiac events associated with loud noise versus swimming among subjects with the long QT syndrome |journal=Am. J. Cardiol. |volume=84 |issue=8 |pages=876–9 |date=October 1999 |pmid=10532503 |doi=10.1016/s0002-9149(99)00458-0 |url=}}</ref> | |||
**[[chest pain]], | |||
**[[shortness of breath]], | |||
=== | **[[diaphoresis]], | ||
**[[palpitations]], and | |||
*[ | **[[syncope]]. | ||
*[ | *Physical examination may be positive for [[hypotension]], [[tachycardia]], [[tachypnea]], [[increased JVD]], and an [[S1]]. | ||
*[ | *Eventually, Pulseless ventricular tachycardia ensues and patients become unconscious and unresponsive with no detectable pulse.<ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref> | ||
==References== | ==References== |
Latest revision as of 14:35, 10 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
Pulseless ventricular tachycardia may be symptomatic or asymptomatic. In a young patient with a family history of sudden death, immediate evaluation for an inherited ventricular syndrome is recommended. If symptomatic, the ventricular rate, duration of tachycardia, and the presence of underlying disease determine the kind of symptoms that present.
History
In young patients with a positive family history of sudden death, evaluation for inherited arrhythmia syndromes is warranted.[1] Inherited arrhythmia disorders include:
- Congenital long QT (LQT)[2]
- Brugada syndrome (BrS)[3]
- Hypertrophic cardiomyopathy
- Arrhythmogenic right ventricular dysplasia (ARVD)
- Congenital short QT intervals (SQT)[4]
- Early repolarization syndrome
- Idiopathic ventricular fibrillation (IVF)[5]
Symptoms
- Pulseless ventricular tachycardia can be symptomatic or asymptomatic.
- If symptomatic, the ventricular rate, duration of tachycardia, and the presence of underlying heart disease determine the kind of symptoms that present.
- On initial presentation, patients with impending pulseless ventricular tachycardia may present with signs of inadequate cardiac perfusion such as [6] [7]
- Physical examination may be positive for hypotension, tachycardia, tachypnea, increased JVD, and an S1.
- Eventually, Pulseless ventricular tachycardia ensues and patients become unconscious and unresponsive with no detectable pulse.[8]
References
- ↑ Baldzizhar A, Manuylova E, Marchenko R, Kryvalap Y, Carey MG (September 2016). "Ventricular Tachycardias: Characteristics and Management". Crit Care Nurs Clin North Am. 28 (3): 317–29. doi:10.1016/j.cnc.2016.04.004. PMID 27484660.
- ↑ Schwartz PJ, Periti M, Malliani A (March 1975). "The long Q-T syndrome". Am. Heart J. 89 (3): 378–90. doi:10.1016/0002-8703(75)90089-7. PMID 234667.
- ↑ Chockalingam P, Wilde AA (2014). "Inherited arrhythmia syndromes leading to sudden cardiac death in the young: a global update and an Indian perspective". Indian Heart J. 66 Suppl 1: S49–57. doi:10.1016/j.ihj.2013.11.008. PMC 4237302. PMID 24568830.
- ↑ Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, Kannankeril P, Krahn A, Leenhardt A, Moss A, Schwartz PJ, Shimizu W, Tomaselli G, Tracy C, Ackerman M, Belhassen B, Estes NA, Fatkin D, Kalman J, Kaufman E, Kirchhof P, Schulze-Bahr E, Wolpert C, Vohra J, Refaat M, Etheridge SP, Campbell RM, Martin ET, Quek SC (October 2013). "Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes". Europace. 15 (10): 1389–406. doi:10.1093/europace/eut272. PMID 23994779.
- ↑ Viskin S, Belhassen B (September 1990). "Idiopathic ventricular fibrillation". Am. Heart J. 120 (3): 661–71. doi:10.1016/0002-8703(90)90025-s. PMID 2202193.
- ↑ Barsheshet A, Goldenberg I (June 2011). "Cardiovascular syncope: diagnostic approach and risk assessment". Minerva Med. 102 (3): 223–38. PMID 21593723.
- ↑ Moss AJ, Robinson JL, Gessman L, Gillespie R, Zareba W, Schwartz PJ, Vincent GM, Benhorin J, Heilbron EL, Towbin JA, Priori SG, Napolitano C, Zhang L, Medina A, Andrews ML, Timothy K (October 1999). "Comparison of clinical and genetic variables of cardiac events associated with loud noise versus swimming among subjects with the long QT syndrome". Am. J. Cardiol. 84 (8): 876–9. doi:10.1016/s0002-9149(99)00458-0. PMID 10532503.
- ↑ Foglesong A, Mathew D. PMID 32119354 Check
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