Last reviewed: July 2020
Last updated: March  2020

Summary

Definition

History and exam

Other diagnostic factors

  • medications
  • palpitations
  • fatigue, weakness
  • chest pain
  • shortness of breath, cough
  • nausea, vomiting
  • lightheadedness, syncope
  • rales
  • edema

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

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

Contributors

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 reviewersVIEW ALL

Associate Professor of Emergency Medicine

University of Maryland Medical Center

Baltimore

MD

Disclosures

AM declares that he has no competing interests.

Consultant Cardiologist

Royal Brompton & Harefield NHS Trust

Imperial College London

London

UK

Disclosures

VM declares that he has no competing interests.

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