January 2022: Not Everything is Anxiety

​A 30ish-year-old woman had been shopping and felt dizzy. The shop owner called 911. She said she had a history of anxiety. This is her ECG.​ Her heart rate was about 125 bpm with a blood pressure hovering around 110 systolic. She didn't have specific complaints, but said she just didn't feel right. No P waves were seen on the ECG. Adenosine for this narrow complex tachycardia.The nurse had questions, though. Didn't supraventricular tachycardia usually have a rate between 150-250 bpm? This patient's rate was slow; was adenosine really the right choice? Shouldn't she be able to handle a rate of 125?​ The answer from cardiology was that the patient had an atrioventricular nodal reentrant tachycardia (AVNRT). They noted that:nAVNRT is the most common paroxysmal SVT.nThe incidence is 2:1 female:male.nRates are 120-240 bpm.nThis can present at any age.n​Dizziness, shortness of breath, and palpitations are common.These episodes can start and stop suddenly, and patients may have been diagnosed with anxiety or panic attacks when the arrhythmia was not picked up.Tip to RememberAn anxious woman can have an underlying medical cause, even a young woman. That heart rate of 120 or 130 bpm might not be sinus tachycardia. Make sure to take a look.​Published: 1/4/2022 8:30:00 AM
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs