Tachycardia: Difference between revisions
→Ventricular tachycardia
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=Ventricular tachycardia= | =Ventricular tachycardia= | ||
Ventricular tachycardias are rhythm disturbances that arise in the ventricles. | Ventricular tachycardias (VT's) are rhythm disturbances that arise in the ventricles. | ||
===History=== | |||
Symptoms can arise in every ventricular tachycardia, depending on the heart rate, the presence of underlying heart disease and the degree of systolic heart failure. Various symptoms are: | |||
* Palpitations | |||
* Abnormal chest sensation | |||
* Angina | |||
* Presyncope (lightheadedness, weakness, diaphoresis) | |||
* Syncope | |||
* Cardiogenic shock | |||
Additional information about drug is mandatory. Toxic levels of digoxin and cocain can lead to VT's. | |||
===Physical Examination=== | |||
Although the diagnosis of VT is generally made by a 12 lead ECG, the following physical symptoms may be present: | |||
* Cannon "A" waves on the jugular venous pulse in the neck. These represent intermittant retrograde propulsion of blood into the jugular veins during right atrial contraction against a closed AV valve. This is evidence of AV dissociation. | |||
* Decreased or variable amplitude of the carotid or peripheral pulses. This is related to the intermittent periods of atrial and ventricular synchronization, which transiently augment cardiac output. | |||
* Variable intensity of the first heart sound (although this is difficult with a rapid heart rate). | |||
* Variable splitting of the first and second heart sounds, and intermittent presence of a third and/or fourth heart sound. | |||
==Ventricular tachycardia== | ==Ventricular tachycardia== | ||