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Tachycardia: Difference between revisions
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→Differentiation between SVT and VT
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==Differentiation between SVT and VT== | ==Differentiation between SVT and VT== | ||
To differentiate between supraventricular tachycardias and ventricular tachycardias a 12 lead ECG is the cornerstone of the diagnostic process. At first, the physician has to make a differentiation between a | To differentiate between supraventricular tachycardias and ventricular tachycardias a 12 lead ECG is the cornerstone of the diagnostic process. At first, the physician has to make a differentiation between a narrow or wide complex tachycardia. | ||
===Definitions=== | ===Definitions=== | ||
'''Narrow complex tachycardia:''' QRS duration < 120 ms. | |||
A narrow complex tachycardia is most likely to be a SVT. However, also a septal VT or His-tachycardia can appear as a narrow complex tachycardia. | A narrow complex tachycardia is most likely to be a SVT. However, also a septal VT or His-tachycardia can appear as a narrow complex tachycardia. | ||
'''Wide complex tachycardia:''' QRS duration > 120 ms. | |||
A wide complex tachycardia can be due to a SVT with aberration, pre-exited tachycardia (eg antidrome re-entry tachycardia) or VT. | A wide complex tachycardia can be due to a SVT with aberration, pre-exited tachycardia (eg antidrome re-entry tachycardia) or VT. | ||
===Differentiation=== | ===Differentiation=== | ||
These are the flow charts of a small and wide complex tachycardia to differentiate between the different rhythms: | These are the flow charts of a small and wide complex tachycardia to differentiate between the different rhythms: | ||
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===Treatment=== | ===Treatment=== | ||
'''Haemodynamical | '''Haemodynamical instability (systolic blood pressure less than 100 mmHg):''' | ||
* | *electrical cardioversion | ||
''' | '''Haemodynamical stability in a regular small complex tachycardia:''' | ||
*Carotid massage (after palpation and ausculatation of carotid arteries for exclusion of carotid occlusion/stenosis) | *Carotid massage (after palpation and ausculatation of carotid arteries for exclusion of carotid occlusion/stenosis) | ||
*Vasalva manoeuvre | *Vasalva manoeuvre | ||