PSVT

A 37 years old female form Thiruvannamalai, Tamilnadu came to JIPMER hospital, cardiology OPD with chief complaints of palpitation one episode, one week back, which was acute in onset, remain for one hour, patient went to  local hospital and palpitation relived after giving intravenous injection the nature of which  was not know. Following which patient referred to JIPMER hospital for further management. During evaluation in the OPD patient pulse was 70 beats per minute, BP-110/70 mmhg. Her ECHOcardiography was normal. 

ECG of the patient during tachycardia 1(Click on the image to enlarge it )

Description of the ECG-Narrow QRS complex tachycardia  with heart rate 180 beats per minute, Inverted P wave seen in lead II,III, avF, Positive P wave seen in lead V1, RP interval 140 msec, PR interval 240 msec, QRS alternans present, No ST-T wave changes seen, so it is short RP tachycardia with RP interval 140 msec

                                       ECG 2 (After tachycardia reverted to normal sinus rhythm)

Sinus ECG-Normal sinus rhythm at 78 beats per minute, No pre-excitation seen, NO ST-T wave changes seen.

So the diagnosis of this patient is Paroxysmal supraventricular tachycardia (PSVT) Differential diagnosis being AVRT or AVNRT/Atrial tachycardia

Patient underwent electrophysiological study at JIPMER hospital which was suggestive of AVRT with concealed left accessory pathway.

            Let see how to  approach in a patient with narrow QRS complex regular tachycardia

                                                                           ECG 3

Thank you.