Ventricular tachycardia physical examination
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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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
Physical findings depend in part on the P-to-QRS relationship with/without signs of AV dissociation.
Vitals
- Vitals are generally unaffected by carotid sinus massage, although this maneuver may slow the atrial rate and, in some cases, expose AV dissociation.
=Blood Pressure
- Hemodynamic compromise (hypotension, shock) are often, but not always present.
- 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.
Neck
- Intermittent cannon A waves can be observed on examination of the jugular pulsation in the neck, and they reflect simultaneous atrial and ventricular contraction.
Heart
- 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.
- Look for evidence of preexisting conditions like a pacemaker/AICD or scar mark from previous cardiothoracic surgery.