Ventricular tachycardia physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in Chief: Avirup Guha, M.B.B.S.[2]
Physical Examination[1]
- Physical findings depend in part on the P-to-QRS relationship with/without signs of AV dissociation are absent.
- AV dissociation is present, although not always evident, in approximately 20% to 50% of patients with VT.
- Intermittent cannon A waves can be observed on examination of the jugular pulsation in the neck, and they reflect simultaneous atrial and ventricular contraction.
- Highly inconsistent fluctuations in the blood pressure can occur because of the variability in the degree of left atrial (LA) contribution to LV filling, stroke volume, and cardiac output.
- Variability in the occurrence and intensity of heart sounds (especially S1) may also be observed and is heard more frequently when the rate of the tachycardia is slower.
- VTs are generally unaffected by carotid sinus massage, although this maneuver may slow the atrial rate and, in some cases, expose AV dissociation.
- Look for evidence of preexisting conditions like a pacemaker/AICD or scar mark from previous cardiothoracic surgery.
References
- ↑ Zipes DP, Jalife J(2009). Cardiac electrophysiology: from cell to bedside (5th ed.). Philadelphia, Pa: Saunders Elsevier.