A physical examination during a PSVT episode will show a rapid heart rate. It may also show bounding pulses in the neck.
The heart rate may be over 100, and even more than 250 beats per minute (bpm). In children, the heart rate tends to be very high. There may be signs of poor blood circulation such as light-headedness. Between episodes of PSVT, the heart rate is normal (60 to 100 bpm).
An ECG during symptoms shows PSVT. An electrophysiology study (EPS) may be needed for an accurate diagnosis and to recommend the best treatment.
Because PSVT comes and goes, to diagnose it patients may need to wear a 24-hour Holter monitor. For longer periods of time, another tape of the rhythm recording device may be used.
If you do not have symptoms or any other heart condition, PSVT may not need treatment.
If you have an episode of PSVT, there are techniques you can try on your own to interrupt the fast heartbeat.
One is called the Valsalva maneuver. To do this, you hold your breath and strain, as if you were trying to have a bowel movement.
Another technique you can try is to cough while sitting with your upper body bent forward.
Some people find that splashing ice water on the face is helpful.
You should avoid smoking, caffeine, alcohol, and illicit drugs.
Emergency treatment to slow the heartbeat back to normal may include:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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