Last reviewed: 7 May 2023
Last updated: 04 Mar 2020
Summary
Definition
History and exam
Key diagnostic factors
- cardiac disease
More key diagnostic factors
Other diagnostic factors
- medications
- palpitations
- fatigue, weakness
- chest pain
- shortness of breath, cough
- nausea, vomiting
- lightheadedness, syncope
- rales
- edema
Other diagnostic factors
Risk factors
- coronary artery disease
- substance misuse (alcohol ingestion/withdrawal, cocaine, amphetamines)
- digoxin toxicity
- exacerbation of chronic lung disease
- previous cardiac surgery to correct congenital heart defects
More risk factors
Diagnostic investigations
1st investigations to order
- ECG
- digoxin level
- theophylline level
- CXR
- electrolytes
- toxicology screen
More 1st investigations to order
Investigations to consider
- vagal maneuvers, adenosine
- thyroid-stimulating hormone
- echocardiogram
- ambulatory 24-hour (Holter) ECG or event recorder
- electrophysiologic study (EPS)
More investigations to consider
Treatment algorithm
INITIAL
adult: undifferentiated supraventricular tachycardia
ACUTE
adult: focal AT; digoxin excess not suspected
adult: focal AT; digoxin toxicity suspected
child
ONGOING
adult: sustained or recurrent focal AT
Contributors
Authors
Sarah Stahmer, MD
Associate Professor
Department of Emergency Medicine
University of North Carolina
Chapel Hill
NC
Disclosures
SS declares that she has given lectures regionally and nationally that include paroxysmal atrial tachycardia.
Peer reviewers
Amal Mattu, MD
Associate Professor of Emergency Medicine
University of Maryland Medical Center
Baltimore
MD
Disclosures
AM declares that he has no competing interests.
Vias Markides, MB(Hons), BS(Hons), MD, FRCP
Consultant Cardiologist
Royal Brompton & Harefield NHS Trust
Imperial College London
London
UK
Disclosures
VM declares that he has no competing interests.
Differentials
- Sinus tachycardia
- AV node re-entry tachycardia
- Atrial flutter
More DifferentialsGuidelines
- 2019 ESC guidelines for the management of patients with supraventricular tachycardia
- ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia
More GuidelinesPatient leaflets
Atrial fibrillation: what is it?
Atrial fibrillation: what treatments work?
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