Ventricular tachycardia (patient information): Difference between revisions

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* [[Chest discomfort]] ([[Angina]])
* [[Chest discomfort]] ([[Angina]])
* [[Fainting]] ([[syncope]])
* [[Fainting]] ([[syncope]])
* [http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm Light-headedness] or [http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm dizziness]
* [[Light-headedness]] or [[dizziness]]
* Sensation of feeling the heart beat ([http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm palpitations])
* [[Sensation of feeling the heart beat]] ([[palpitations]])
* [http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Shortness of breath]
* [[Shortness of breath]]


Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms.
Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms.

Revision as of 04:56, 17 September 2012

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Ventricular tachycardia Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ventricular Tachycardia from other Disorders

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Echocardiography

Cardiac MRI

Other Diagnostic Tests

Treatment

Medical Therapy

Electrical Cardioversion

Ablation

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Ventricular tachycardia (VT) is a rapid heartbeat that starts in the ventricles.

Causes

Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row.

The condition can develop as an early or late complication of a heart attack. It may also occur in patients with:

Ventricular tachycardia can occur without heart disease.

Scar tissue may form in the muscle of the ventricles days, months, or years after a heart attack. This can lead to ventricular tachycardia.

Ventricular tachycardia can also be caused by:

"Torsade de pointes" is a form of ventricular tachycardia that is often due to congenital heart disease or the use of certain medications.

Symptoms

If the heart rate during a ventricular tachycardia episode is very fast or lasts longer than a few seconds. There may be symptoms such as:

Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms.

Exams and Tests

Signs include:

Ventricular tachycardia may be seen on:

Blood chemistries and other tests may be done.

Treatment

Treatment depends on the symptoms, and the type of heart disorder. Some people may not need treatment.

If ventricular tachycardia becomes an emergency situation, it may require:

Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as procainamide, amiodarone, or sotalol). However, anti-arrhythmic medications may have severe side effects. Their use is decreasing in favor of other treatments.

Some ventricular tachycardias may be treated with an ablation procedure. Radiofrequency catheter ablation can cure certain tachycardias.

A preferred treatment for many chronic (long-term) ventricular tachycardias consists of implanting a device called implantable cardioverter defibrillator (ICD). The ICD is usually implanted in the chest, like a pacemaker. It is connected to the heart with wires.

The doctor programs the ICD to sense when ventricular tachycardia is occurring, and to administer a shock to stop it. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia. You may need to take anti-arrhythmic drugs to prevent repeated firing of the ICD.

Outlook (Prognosis)

The outcome depends on the heart condition and symptoms.

Possible Complications

Ventricular tachycardia may not cause symptoms in some people. However, it may be lethal in other people. It is a major cause of sudden cardiac death.

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have a rapid, irregular pulse, faint, or have chest pain. All of these may be signs of ventricular tachycardia.

Prevention

In some cases, the disorder is not preventable. In other cases, it can be prevented by treating heart diseases and correcting blood chemistries.

Alternative Names

Wide-complex tachycardia; V tach; Tachycardia - ventricular

References

Olgin JE, Zipes DP. Specific Arrhythmias: Diagnosis and Treatment. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 35.

Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. ACC/AHA,HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC?AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 117:e350-e408.