Pulseless ventricular tachycardia natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
*On initial presentation, patients with impending [[pulseless ventricular tachycardia]] may present with signs of inadequate [[cardiac perfusion]] such as [[chest pain]], [[shortness of breath]], [[diaphoresis]], [[palpitations]], and [[syncope]]. Physical examination may be positive for [[hypotension]], [[tachycardia]], [[tachypnea]], [[increased JVD]], and an [[S1]]. Eventually, Pulseless ventricular tachycardia ensues and patients become unconscious and unresponsive with no detectable pulse. If [[defibrillation]] is not begun as soon as possible patients may progress to cardiac arrest and death. <ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref> | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
* | *On initial presentation, patients with impending [[pulseless ventricular tachycardia]] may present with signs of inadequate [[cardiac perfusion]] such as [[chest pain]], [[shortness of breath]], [[diaphoresis]], [[palpitations]], and [[syncope]]. | ||
*Physical examination may be positive for [[hypotension]], [[tachycardia]], [[tachypnea]], [[increased JVD]], and an [[S1]]. | |||
* | *Eventually, Pulseless ventricular tachycardia ensues and patients become unconscious and unresponsive with no detectable pulse.<ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref> | ||
===Complications=== | ===Complications=== | ||
*Common complications of [ | *Common complications of pulseless ventricular tachycardia include: | ||
**[ | **[[Cardiac arrest]]/[[sudden cardiac death]] | ||
**[ | **[[Anoxic brain injury]] and lifelong neurological complications | ||
**[ | **[[Post-cardiac arrest syndrome]] | ||
**[[Ischemic-reperfusion injury]] | |||
**[[Cardiomyopathy]] | |||
**Infection related to [[implantable cardioverter-defibrillator]] | |||
===Prognosis=== | ===Prognosis=== | ||
*Prognosis is | *[[Prognosis]] of pulseless ventricular tachycardia is majorly based on two considerations; the presence of prior expressed or unexpressed cardiac issues, and the time from the beginning of the [[dysrhythmia]] to [[defibrillation]] and conversion to [[sinus rhythm]]and adequate [[perfusion]].<ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref> | ||
* | *Up to 50% of patients who are defibrillated within seconds of the onset of [[tachycardia]], have high survival rates while patients who experience delays of up to 15 minutes have a survival rate of as low as 5%.<ref name="pmid10699695">{{cite journal |vauthors=Holmberg M, Holmberg S, Herlitz J |title=Incidence, duration and survival of ventricular fibrillation in out-of-hospital cardiac arrest patients in sweden |journal=Resuscitation |volume=44 |issue=1 |pages=7–17 |date=March 2000 |pmid=10699695 |doi=10.1016/s0300-9572(99)00155-0 |url=}}</ref> | ||
*While the most significant factors affecting prognosis are underlying structural and ischemic cardiac issues, the presence of other [[comorbidities]] also play a significant role.<ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref> | |||
* | |||
==References== | ==References== | ||
Revision as of 11:17, 7 June 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
- On initial presentation, patients with impending pulseless ventricular tachycardia may present with signs of inadequate cardiac perfusion such as chest pain, shortness of breath, diaphoresis, palpitations, and syncope. Physical examination may be positive for hypotension, tachycardia, tachypnea, increased JVD, and an S1. Eventually, Pulseless ventricular tachycardia ensues and patients become unconscious and unresponsive with no detectable pulse. If defibrillation is not begun as soon as possible patients may progress to cardiac arrest and death. [1]
Natural History, Complications, and Prognosis
Natural History
- On initial presentation, patients with impending pulseless ventricular tachycardia may present with signs of inadequate cardiac perfusion such as chest pain, shortness of breath, diaphoresis, palpitations, and syncope.
- Physical examination may be positive for hypotension, tachycardia, tachypnea, increased JVD, and an S1.
- Eventually, Pulseless ventricular tachycardia ensues and patients become unconscious and unresponsive with no detectable pulse.[1]
Complications
- Common complications of pulseless ventricular tachycardia include:
- Cardiac arrest/sudden cardiac death
- Anoxic brain injury and lifelong neurological complications
- Post-cardiac arrest syndrome
- Ischemic-reperfusion injury
- Cardiomyopathy
- Infection related to implantable cardioverter-defibrillator
Prognosis
- Prognosis of pulseless ventricular tachycardia is majorly based on two considerations; the presence of prior expressed or unexpressed cardiac issues, and the time from the beginning of the dysrhythmia to defibrillation and conversion to sinus rhythmand adequate perfusion.[1]
- Up to 50% of patients who are defibrillated within seconds of the onset of tachycardia, have high survival rates while patients who experience delays of up to 15 minutes have a survival rate of as low as 5%.[2]
- While the most significant factors affecting prognosis are underlying structural and ischemic cardiac issues, the presence of other comorbidities also play a significant role.[1]
References
- ↑ 1.0 1.1 1.2 1.3 Foglesong A, Mathew D. PMID 32119354 Check
|pmid=value (help). Missing or empty|title=(help) - ↑ Holmberg M, Holmberg S, Herlitz J (March 2000). "Incidence, duration and survival of ventricular fibrillation in out-of-hospital cardiac arrest patients in sweden". Resuscitation. 44 (1): 7–17. doi:10.1016/s0300-9572(99)00155-0. PMID 10699695.