Have you ever noticed, or experienced, your heart suddenly beating very fast? Sometimes this can be normal, but sometimes it can be a cause for concern. Today we are going to talk about a condition called
Monomorphic Ventricular Tachycardia , in which the heart rate increases abnormally. Although the name is a bit long, let's keep it simple.
What is Monomorphic Ventricular Tachycardia?
Simply put, this is an irregular heartbeat, or
arrhythmia . This is when the lower chambers of your heart, called
the ventricles , start beating at a very dangerous rate. Depending on how and when this happens, it can become a dangerous, even life-threatening problem. Imagine, this condition of
Ventricular Tachycardia (VT) , can become even more severe and turn into a deadly arrhythmia called
Ventricular Fibrillation (V-fib) . If that happens, the heart can stop. If you are with someone and they suddenly become unconscious and have no pulse,
it is very important to immediately call 911 (or the relevant emergency number), quickly begin CPR (Cardiopulmonary Resuscitation), and find an AED (Automated External Defibrillator) if one is nearby. If you don't know how to give CPR , emergency responders are often trained to teach you how to give CPR over the phone. If you're in a public place, many buildings and institutions have AEDs . These are invaluable tools that can save lives in times like these.
What does the name of this condition mean?
The name "monomorphic ventricular tachycardia" breaks down into its parts and means:
- Mono (Mono-) : One.
- -morphic : shape.
- Ventricular : Connects to the lower chambers of your heart, the left and right ventricles .
- Tachy- : Fast.
- -cardia : heart .
That is,
ventricular tachycardia (VT) is a condition in which the lower chambers of your heart beat rapidly, but do not pump blood properly. This is usually caused by abnormal electrical circuits in the ventricular muscle. The word "monomorphic" comes from the way this heart rhythm
is recorded on an electrocardiogram (ECG).One – we call it
ECG or
EKG – is based on how it looks. In monomorphic
VT , all the waves on the
ECG look the same, uniform shape. About 70% of
VT patients have this monomorphic type. An
ECG measures the electrical activity of the heart using several sensors, called
electrodes (usually 12), that are attached to the skin of your chest. These electrodes capture the electrical activity and display it as a series of waves on paper or a screen. Monomorphic
VT means that all of these waves look the same shape.
There are two main subtypes of monomorphic VT:
There are two main forms of this condition:
- Non-sustained : This type of monomorphic VT lasts for more than three beats in a row, but less than 30 seconds. However, it can occur repeatedly. When this happens, it can be difficult to recognize.
- Sustained : This is monomorphic VT that lasts longer than 30 seconds, or requires some treatment to return the heart to a normal rhythm.
What is the difference between monomorphic ventricular tachycardia and polymorphic ventricular tachycardia?
Polymorphic Ventricular Tachycardia is a condition similar to monomorphic
VT , but with one major difference. "Polymorphic" means "different shapes." On an
ECG , the waves of polymorphic
VT change from one beat to the next. This means that the electrical activity of your heart is more erratic than in monomorphic
VT .
Who is affected the most by this situation?
Ventricular tachycardia is more common
in men . It affects adults, especially the elderly, and those with heart disease, especially those with reduced
ejection fraction . It can also occur in children, but it is very rare. It usually occurs in people with
structural heart diseases that are present at birth. Also, conditions that cause
ventricular tachycardia , such as
Brugada syndrome or
arrhythmogenic right ventricular cardiomyopathy, can be inherited.
How common is this condition?
In the United States alone
, ventricular tachycardia and the associated arrhythmia called
ventricular fibrillation cause about 300,000 deaths per year.
How does this condition affect my body?
Monomorphic ventricular tachycardia is usually caused by a problem with your heart's electrical system. The problem causes the ventricles to beat so fast that they don't have time to fill with blood before they have to beat again. The ventricles can also beat at the wrong time, causing them to lose their rhythm with the upper chambers of the heart.
Ventricular tachycardia can get worse and become
ventricular fibrillation (V-fib) . This is also a condition where the lower chambers of the heart can't fill with blood, but it's more serious. In
V-fib , the ventricles don't beat properly, but instead they just quiver. Because the heart doesn't pump blood properly,
ventricular fibrillation can easily lead to
cardiogenic shock or
sudden cardiac arrest . This means your heart can't pump enough blood to meet your body's needs.
Ventricular tachycardia can sometimes go straight to heart attack without going into
V-fib .
Sudden cardiac arrest is a condition that can be fatal within minutes if
CPR isn't given immediately (often called
Sudden Cardiac Death if the patient can't be saved).
What are the symptoms of monomorphic ventricular tachycardia?
Some people may have monomorphic
VT but not have any symptoms. If there are no symptoms,
the VT is usually short-lived and not severe. Symptoms of monomorphic
VT include:
- Rapid pulse (or no pulse) : In monomorphic VT , your heart rate is usually between 140 and 180 beats per minute (higher values are usually worse, and you're more likely to have symptoms). In some cases, you may lose your pulse altogether, which means you're having a heart attack.
- Heart palpitations : This is an uncomfortable feeling of your heart beating without feeling a pulse. It can feel like your heart is racing, pounding, skipping, or fluttering.
- Chest pain (Angina) : This happens when your heart doesn't get enough blood flow.
- Dizziness or lightheadedness : This happens when your heart is not pumping enough blood to supply the brain with the oxygen it needs.
- Syncope : This can occur after dizziness when VT is severe. It can be a complete loss of consciousness or a continuous state of near-syncope.
- Dyspnea : Poor blood circulation causes your body to lack oxygen, making it feel like it's hard to breathe.
What causes monomorphic ventricular tachycardia?
Monomorphic
VT can be caused by a variety of reasons. Some of them include:
- Ischemic heart disease : Ischemia, which is reduced blood flow, can disrupt your heart's electrical system and cause monomorphic VT .
- Cardiomyopathy : People with weak and scarred hearts (due to various causes, for example, ischemia) can develop abnormal electrical circuits that can lead to VT .
- Pre-existing arrhythmias : Conditions that disrupt your heart's electrical system can develop on their own, or they can be present from birth. An example of this is Brugada syndrome .
- Structural heart problems : Your heart's electrical system depends on the shape of your heart. When that shape changes, the distance that electrical current travels can increase or decrease. These changes can cause the timing of different steps in your heartbeat to be out of sync, causing monomorphic VT . You can have structural heart conditions that you are born with, some of which you inherit from your parents.
- Electrolyte imbalances : These occur when your body has too much (or not enough) of certain minerals that your heart cells need to function properly.
- Medications and drugs : Prescription medications (such as digitalis ) and drugs (such as methamphetamine or cocaine ) can cause monomorphic VT .
- Myocarditis : This is an inflammation of the heart muscle. It can be caused by a variety of factors, including infection.
- Other conditions : Conditions such as cardiac amyloidosis , lupus, or rheumatoid arthritis can also cause monomorphic VT .
Is this contagious?
Monomorphic
VT is not contagious, so it is not spread from one person to another. However, some of the conditions that cause it are genetic. This means that children can inherit it from their parents. It can also be caused by inflammation caused by infections, which can sometimes be contagious.
How is monomorphic ventricular tachycardia diagnosed?
To diagnose monomorphic
VT , an
ECG test must be performed in a hospital. A doctor can use this test
toThis condition can be diagnosed by the waveform it shows. The only way to diagnose monomorphic
VT is with an
ECG . This is because it is the only way to see the uniform waveform of the heart's electrical activity. If you have
non-sustained monomorphic VT , which means it comes and goes, you will need to have tests that use the same principles as
an ECG , but do not require you to stay in the hospital. These are called
ambulatory monitors . These are devices that can record
ECG data over a long period of time. You can take them home and wear them for days or even weeks, depending on the type of monitor.
How is monomorphic ventricular tachycardia treated? Can it be cured?
If you don't have
sustained ventricular tachycardia and don't have any symptoms, you may not need treatment for
ventricular tachycardia . However, your doctor will often advise you to watch for signs that this condition could be a problem for you. Because
sustained ventricular tachycardia can lead to a heart attack (either directly or by turning into
V-fib ), it's important to get your heart back into a normal rhythm. This may often require one or more treatments, ranging from medications to surgery. Depending on the cause of monomorphic
VT , it can usually be treated, but it can't always be cured. Whether or not your condition can be cured often depends on the underlying cause.
What medications and treatments are used for monomorphic ventricular tachycardia?
Treatment for monomorphic
VT usually includes one or more of the following:
- Medications : Anti-arrhythmia medications can greatly reduce the risk of complications and death from ventricular tachycardia . Other medications can also help your heart return to a normal rhythm. Some of these medications are only given to you in the hospital, because they are given directly into your body through an intravenous (IV) line or by injection. Other medications you can take daily as pills.
- Electric defibrillation : This involves using an electric current to "shock" your heart into a normal rhythm. This is usually reserved for when your overall condition is unstable, for example, when your blood pressure is very low due to ventricular tachycardia .
- Chest compressions : These are the same techniques used in CPR . This is what is usually done immediately if you are having a heart attack due to ventricular tachycardia . If you have a pulse, these are not needed.
- Oxygen, intubation, and ventilation : Giving you extra oxygen (such as through a tube under your nose) can help reduce the strain on your heart. If your condition becomes so unstable that you can't breathe, you may need to be intubated . This involves putting a tube down your throat and into your windpipe. The tube is connected to a machine called a ventilator , which does the work of breathing for you.
- Implantable Cardioverter-Defibrillators (ICDs) : If you have monomorphic VT , implantable devices can protect you from heart attacks. An ICD is a device that a surgeon can place in your chest and connect to your heart with wires (called leads ). An ICD can detect an arrhythmia and deliver a small electrical shock to restore your heart to a normal rhythm.
- Ablation : In some cases, healthcare providers can create scar tissue in your heart to break the electrical circuits that cause monomorphic VT . This procedure is called ablation . This can be done surgically or through a catheter. With a catheter, a healthcare provider inserts a tube-like device into a major blood vessel (usually one in your upper thigh) and guides it up to your heart. Once in the heart, they use very precise heat or extreme cold energy to create a scar that breaks the faulty electrical circuit.
Complications/side effects of treatment
The complications and side effects you may experience from these treatments can vary greatly. Your doctor is the best person to tell you what is most likely to happen in your case, as he or she can take into account the treatments you need (or have already received), your health history, and any specific conditions.
How do I take care of myself/manage symptoms?
Because an
ECG is required to diagnose monomorphic
VT , you can't know you have it without seeking medical advice. That means you can't treat it on your own without seeing a doctor.
How quickly will I feel better after treatment?
Many people start to feel better after treatment, especially if the treatment slows their heart rate and returns their heart to a normal rhythm. In other cases, you may need additional treatment or surgery before you start to feel better. If you need surgery, you may not feel completely well until after the procedure. Your doctor is the best person to talk to about what your recovery time will be like and whether there is anything you can do to help you recover faster.
Can I reduce the risk of this happening or prevent it altogether?
Most of the time, monomorphic
VTIt is an unpredictable problem. It means that it cannot be prevented. The only way to prevent it is to avoid situations or activities that make you more likely to get it. An example of this is to avoid using drugs like
methamphetamine or
cocaine . If you have another condition that causes monomorphic
VT , you may be able to reduce your risk
of VT by avoiding or delaying that condition. However, this is not always possible. If monomorphic
VT is caused by an inherited or congenital condition, it cannot be prevented.
If I have this condition, what should I expect?
If you have no symptoms of monomorphic
VT , you may not need medical attention. If you have symptoms of monomorphic
VT , you need
immediate emergency medical attention . This is because
ventricular tachycardia can easily lead to a heart attack (either straight away or by turning into
V-fib ).
How long does monomorphic VT last?
This condition can be very brief, lasting only a few moments at a time, or it can last for a few minutes. However, this condition is dangerous, so you should not let it continue. That is why emergency medical treatment is so important to prevent complications or death.
What is the outlook for this situation?
Non-sustained ventricular tachycardia , especially if it's asymptomatic, is usually not a harmful problem. If you have
sustained monomorphic VT , especially if it's symptomatic, you need emergency medical treatment. Without that treatment, your heart could develop a worse arrhythmia or stop altogether.
How do I take care of myself?
Your doctor is the best person to guide you on what you can do to take care of yourself after being diagnosed with monomorphic
VT . In general, you should do these things:
- Take your medications as prescribed . This is very important, because medications can help prevent your heart rhythm from changing to monomorphic VT . You should not stop taking your medications without talking to your doctor. If you have any questions about taking or storing your medications, talk to your doctor or pharmacist for more information.
- See your doctor as recommended . Follow-up care and medical visits are very important to prevent complications or other problems from this condition.
When should I see my doctor?
You should see your doctor regularly as recommended. You should see your doctor if you start to have symptoms, or if your symptoms change and start to interfere with your life. Also, ask your doctor about any other symptoms or warning signs that may require you to call your doctor's office or seek medical attention.
When should I go to the Emergency Department (ETU) ?
If you have any of the symptoms of monomorphic
VT , you should go to the hospital's emergency room. This is because the symptoms of this condition are very similar to those seen in other dangerous conditions, such as
a heart attack or
pulmonary embolism . Symptoms to watch out for include:
- Chest pain ( angina ).
- Feeling your heart pounding.
- Difficulty breathing.
- Dizziness or feeling light-headed.
- Dreaming.
Finally, take-home message:
Monomorphic ventricular tachycardia is a potentially dangerous condition. If you have symptoms of this condition, it is important to seek medical attention right away. The sooner you seek treatment, the more likely it is that your healthcare provider will be able to diagnose and treat your condition before it gets worse. While this condition cannot always be cured, it can usually be treated so that you can get back to your life and the activities you enjoy most.
The most important thing is to stay calm and follow your doctor's instructions. Heart palpitations, tachycardia, arrhythmia, ECG, heart disease, ventricular fibrillation, sudden cardiac arrest
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