About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Drug of Choice for Supraventricular Tachycardia (SVT)
Introduction
Supraventricular tachycardia (SVT) is a rapid heart rhythm originating above the ventricles, typically involving the atria or the atrioventricular (AV) node. It often presents with symptoms such as palpitations, dizziness, or shortness of breath. The treatment approach depends on the clinical presentation and whether the patient is hemodynamically stable or unstable.
Treatment Approaches
1. Immediate Management (Acute Episodes)
- Vagal Maneuvers: First-line treatment for stable patients. Techniques such as the Valsalva maneuver or carotid sinus massage may help terminate the arrhythmia.
- Adenosine (First-line pharmacologic choice):
- Initial dose: 6 mg IV rapid push, followed by a flush.
- If ineffective, a second dose of 12 mg IV may be given.
- Temporarily blocks the AV node, interrupting the re-entrant circuit.
- If adenosine is contraindicated or ineffective:
- Calcium Channel Blockers (e.g., verapamil or diltiazem) or
- Beta-Blockers (e.g., metoprolol, esmolol) can be used.
2. Management of Unstable Patients
- If the patient has hypotension, chest pain, or signs of shock, immediate synchronized cardioversion is required.
3. Chronic Prevention (Recurrent SVT)
- Beta-blockers or Calcium Channel Blockers for long-term management.
- Catheter Ablation: Preferred in patients with frequent recurrences or those who do not tolerate medications well.
Conclusion
Adenosine remains the drug of choice for acute management of SVT due to its rapid onset and high efficacy. However, beta-blockers or calcium channel blockers may be used as second-line agents, particularly for chronic therapy.
References
Relevant clinical guidelines:
Source recommendations
1. American Heart Association (AHA) Guidelines on Supraventricular Arrhythmias
- https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate
- https://pubmed.ncbi.nlm.nih.gov/14557344/
- https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
- https://professional.heart.org/en/science-news/-/media/028ddd505f514ea2b3a4e74bb72e3557.ashx
2. European Society of Cardiology (ESC) Guidelines for the Management of Supraventricular Tachycardia
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
- https://academic.oup.com/eurheartj/article/41/5/655/5556821
- https://pubmed.ncbi.nlm.nih.gov/31504425/
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia
- https://pubmed.ncbi.nlm.nih.gov/14563598/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.