Ventricular tachycardia history and symptoms

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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

Family history of sudden death in any young patient is immediate evaluation for inherited arrhythmia syndromes. 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.

For patents presenting with VT, history of underlying heart disease, other comorbidities, medications, and family history of SCD in first relative should be taken.

Bellow table shown clinical history related to VT:

Components	Assessment and findings
Symptoms	Symptoms related to arrhythmia^[1]^[2] Palpitations, lightheadedness, syncope, dyspnea, chest pain, cardiac arrest Symptoms related to underlying heart disease: Dyspnea at rest or on exertion, orthopnea, paroxysmal nocturnal dyspnea, chest pain, edema Precipitating factors: Exercise, emotional stress
Past medical history	Heart disease: Coronary, valvular (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 Use of over-the-counter medications caused QT prolongation and torsades de pointes Unexplained motor vehicle accident
Medications	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
Family history	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

↑ 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.
↑ 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.
↑ 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.
↑ 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.