Question
A 28 yr old female comes to ER with h/o sudden onset dyspnoea, palpitations, anxiety, and sweating. Also has h/o fever, cough for 2 days. On evaluation, the patient’s ECG is as below. ECHO- normal. What is the most possible diagnosis?
| A. |
Junctional escape rhythm
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| B. |
Atrial fibrillation
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| C. |
Paroxysmal Supraventricular tachycardia
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| D. |
Sinus tachycardia
|
Show Answer
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Correct Answer � C
Explanation
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|
Ans. C
Explanation :
· SVT often used synonymously with AV nodal reentry tachycardia (AVNRT), can be used to refer to any tachydysrhythmia arising from above the level of the Bundle of His.
· Paroxysmal SVT (PSVT) describes an SVT with an abrupt onset and offset — characteristically seen with reentrant tachycardias involving the AV node such as AVNRT or atrioventricular reentry tachycardia (AVRT)
· AVNRT (commonest cause) is typically paroxysmal and may occur spontaneously or upon provocation with exertion, caffeine, alcohol, beta-agonists (salbutamol), or sympathomimetics
· It is more common in women than men (~ 75% of cases occurring in women)
and may occur in young and healthy patients as well as those suffering from chronic heart disease.
· General Features of AVNRT
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Regular tachycardia ~140-280 bpm.
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QRS complexes are usually narrow (< 120 ms) unless pre-existing bundle branch block, accessory pathway, or rate-related aberrant conduction.
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ST-segment depression may be seen with or without underlying coronary artery disease.
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P waves may be buried in the QRS complex, visible after the QRS complex, or very rarely visible before the QRS complex.
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