Have you ever experienced a sudden, unimaginable increase in your heart rate, a pounding in your chest, and then a brief moment of normalcy? You may have thought this was just a normal occurrence, or something that happens when you get a little scared. However, sometimes it's not. Today we're going to talk about a condition called `Paroxysmal Supraventricular Tachycardia` or `PSVT`, which causes sudden changes in heart rate. Don't worry, we'll talk about this in a simple way that you can understand.
What is PSVT?
Simply put, `PSVT` is an irregularity in the rhythm of our heart, that is, the pattern of our heartbeat (`arrhythmia`). In this case, the heart suddenly starts beating very fast. Then, just as suddenly, the heart rate slows down to its normal rate again. We call these sudden rapid heartbeats `paroxysms`. This condition is caused by abnormal electrical activity that starts in the two upper chambers of the heart, called the `atria`. We call the two lower chambers of the heart, called the `ventricles`. These four chambers work together to pump blood throughout our body.
So, `PSVT` is caused by an abnormal electrical activity in these atria, which causes them to contract very rapidly and continuously. But the important thing is that `PSVT` is not always a disease that requires treatment or is life-threatening. Sometimes it can be treated without any treatment. If necessary, doctors will recommend medications, some heart disease treatments, and very rarely, a `pacemaker`. If you feel something strange about the way your heart beats, it is definitely best to see a doctor and get it checked out.
How does our heart work normally?
Before we understand what PSVT is, let's take a look at how our heart normally works. In a healthy heart, the heartbeat starts in a small piece of tissue in the atria. We call it the sinoatrial node (SA node). This is what acts like the heart's natural pacemaker.
This `SA node` sends out electrical signals that cause the atria to contract and pump blood. These signals then travel to the ventricles through another small bundle of cells called the `atrioventricular node` (AV node). The `AV node` sends electrical signals to the ventricles to contract. This is how our heart beats in an orderly manner.
Are there types of PSVT?
Yes, there are many other conditions under the broad category of `PSVT`. These can be caused by the presence of more than one extra electrical connection from the upper chambers of the heart to the lower chambers, either directly or through the `AV node`. This causes the heart to beat faster (`tachycardia`). Sometimes, this fast heart rate can also start from an `irritable focus` in the upper chambers of the heart.
Some of the common names for these types of tachycardia are:
- ``Atrioventricular nodal re-entrant tachycardia (AVNRT)''
- ``Orthodromic reciprocating tachycardia (ORT)''
- ``Antidromic reciprocating tachycardia''
- `Atrial tachycardia`
- `Atrial flutter`
Although this may seem a bit scientific, it is important for doctors to understand exactly what your condition is and provide the most appropriate treatment.
How common is this?
Heart rhythm disorders (arrhythmias) are actually very common. Millions of people in Sri Lanka and around the world suffer from some form of heart rhythm disorder.
Supraventricular tachycardias (SVT) are the most common type of heart rhythm disorder, especially in young children and infants. They are also more common in children with congenital heart disease.
Why does this PSVT occur? What are the causes?
PSVT (also called re-entry tachycardia) is a heart rhythm disorder that occurs in the atria. It occurs when there is abnormal electrical activity in the atria. This means that either a hypersensitive area in the atria or a short circuit in the heart's electrical pathways causes the electrical signals to start going in circles. This is when the atria start to contract rapidly and continuously.
These abnormal electrical signals can occur if there is an extra electrical pathway (`extra pathway`) between the atria and ventricles, either directly or through the `AV node`. For example, people with a condition called `Wolff-Parkinson-White syndrome` have this extra pathway in their hearts. Then, if the electrical signals travel through this extra pathway faster than they would through the normal `AV node`, the heart starts to beat too fast.
Like other heart rhythm disorders (arrhythmias), PSVT can be hereditary. This means that if someone in your family has it, you are more likely to develop it. In addition, there are a number of other causes that can cause this condition. Let's take a look at what they are:
- With aging: Because the heart changes with age.
- Anemia: When the body does not get enough oxygen.
- Dehydration and excessive fatigue: These can put strain on the heart.
- Drinks and foods containing caffeine: Things like tea, coffee, chocolate, and some energy drinks.
- Certain foods: Some people may experience palpitations after eating foods high in fat, sugar, or carbohydrates. For example, you may feel your chest pounding after a heavy meal or after a party.
- Some medications: For example, pseudoephedrine, which is found in some decongestants for nasal congestion.
- Excessive alcohol consumption.
- Having had a previous heart attack or heart damage from heart surgery.
- Heart disease: especially coronary artery disease (CAD).
- High blood pressure (Hypertension).
- Severe stress and anxiety: Stress caused by things like an upcoming exam, work problems, or family issues.
- Hormonal changes: During menopause in women, or during pregnancy. In fact, palpitations are very common during pregnancy.
- Obesity (obesity) and overweight.
- Smoking and use of tobacco products.
- Structural problems of the heart: For example, heart valve disease.
- Thyroid problems: especially `Hyperthyroidism` (overactive thyroid gland).
What are the symptoms of PSVT?
PSVT symptoms usually start suddenly and stop suddenly. They can be mild for some people, and severe for others. You may feel this rapid heartbeat after a hard workout, after a day of poor sleep, or during a time of high stress.
The main symptoms are:
- A fast, irregular heart rate. Usually more than 100 beats per minute (BPM), but sometimes as high as 250 BPM. Young children with PSVT may have a heart rate even higher.
- Feeling a throbbing, pounding, or pounding sensation in the chest, throat, or neck (`palpitations`). Some people say it feels like "a drum is beating inside the chest." You may feel a strong, rapid pulse.
- Sudden changes in heart rate. Your heart may beat faster for a few minutes or hours, then suddenly start beating normally again. (The normal heart rate for an adult is between 60 and 100 beats per minute.)
When this `PSVT` condition occurs, you may experience several other symptoms:
- Feeling anxious and dizzy.
- Chest pain, discomfort, or a feeling of tightness in the chest.
- Difficulty breathing or shortness of breath (dyspnea).
- Dizziness and lightheadedness, blue eyes.
- Loss of consciousness (syncope) or fainting.
- Extreme fatigue or tiredness.
- Nausea.
How do you know if you have PSVT?
When you go to see a doctor, he or she will first ask you about your symptoms and listen to your heart with a stethoscope. Then, they will order a blood test. This blood test checks your thyroid function and other problems in your blood.
Next, the doctor will do an electrocardiogram (EKG or ECG). This is a test that can be done in the doctor's office and takes about 15 minutes. An EKG records the electrical activity of your heart and your heart rate through sensors attached to your skin. Sometimes, if you experience PSVT during strenuous exercise, you may be asked to do an exercise stress test.
If the EKG doesn't show an irregular heartbeat, your doctor will likely give you an ambulatory monitor, also known as a Holter monitor or patch monitor, to wear for a few days or even a month. This is a small device that you can wear on your body. It continuously records your heart rate and any irregular heartbeats (if any).
How is PSVT treated?
Depending on your overall health and symptoms, you may not need any treatment. If you have an irregular heart rhythm (an `arrhythmia`), you will be referred to a `cardiologist`. He or she may recommend the following:
- Avoid alcohol and caffeine (tea, coffee, some soft drinks). Also, stop taking some medications that contain pseudoephedrine, such as decongestants.
- Sleep well and rest.
- Drink plenty of water to maintain proper hydration.
- Get help to reduce stress and anxiety, and do relaxation exercises.
- If you are overweight (obese), lose weight and maintain a healthy weight.
- If you smoke, stop it completely.
Also, when you experience this `PSVT` condition, you can ask your doctor about some ways to temporarily slow down your heart rate. These are called `Vagal maneuvers`. Examples:
- Splashing cold water on your face all at once.
- To cough in a special way.
- Close your eyes and gently apply pressure to your eyelids.
Important: Never try these `vagal maneuvers` on your own, without proper training. You should definitely consult your doctor and do them exactly as he or she tells you.
- The `Valsalva maneuver` is another such method. In this, you take a breath in, pinch your nose, hold it as if you were full, and then exhale quickly, as if you were inflating a balloon. This can also reduce your heart rate slightly.
If your heart rate changes frequently, if they cause you discomfort, or if you have other heart conditions, your doctor may recommend treatment. Such treatments include:
- Catheter ablation: This involves causing minor damage to the part of the heart that sends out irregular electrical signals. This is a treatment that involves inserting a small tube (catheter) through a vein, without making a large incision.
- `Carotid sinus massage`: In this, the doctor applies gentle pressure to a specific spot on your neck to slow down your heart rate. This should only be done by a doctor, and you should not do it at home.
- Devices: Sometimes a device such as an `Implantable Cardioverter Defibrillator (ICD), `subcutaneous ICD` or `permanent pacemaker` may be recommended to be implanted in the heart.
- Electrical cardioversion: In this, the heart is given safe electrical shocks (jolts of energy), stopping the irregular rhythm and allowing the heart to beat normally.
- Medications: There are medications that can restore heart rhythm and prevent heart rhythm irregularities.
How to reduce the risk of PSVT?
It may not be possible to completely prevent PSVT. However, you can reduce your risk by following a healthy lifestyle and staying healthy. Here are some things you can do to reduce your risk:
- Follow a heart-healthy diet ( low in oil, salt, and sugar, and high in vegetables, fruits, and greens).
- If you have things (`triggers`) that you know cause this `PSVT` condition, stay away from them.
- Exercise well, stay active, and try to maintain physical fitness.
- If you are overweight, lose weight, talk to your doctor, and maintain a healthy weight.
- If you have high blood pressure (hypertension), control it.
- Maintain healthy cholesterol levels.
- If you smoke, stop it completely.
- If you or your child has a heart condition that increases the risk of PSVT, talk to your doctor about it. He or she will give you specific advice on how to stay healthy and reduce your risk of heart disease.
What happens to someone with PSVT? What is the future?
The outlook for someone with PSVT depends on several factors, including your age and your overall health. You can help manage your symptoms by making lifestyle and dietary changes.
Over time, PSVT can weaken the heart muscle. In severe cases, PSVT can cause loss of consciousness and even sudden cardiac arrest. Therefore, if you have PSVT, it is very important to see your doctor regularly to monitor your heart health.
The good news is that in most cases, PSVT can be completely cured with a treatment called catheter ablation.
When should I see a doctor about PSVT?
If you have any concerns about your heart rate, or if you have symptoms of an irregular heartbeat (arrhythmia), be sure to talk to a doctor. If you have been diagnosed with PSVT, it is very important to see your cardiologist regularly.
If these things happen, seek medical advice immediately:
- If you suddenly feel extremely tired for no apparent reason.
- If you feel faint or lose consciousness.
- If you experience chest pain, difficulty breathing, or shortness of breath.
Finally, what to remember (Take-Home Message)
Paroxysmal Supraventricular Tachycardia (PSVT) can be scary when it occurs. However, it is not usually life-threatening or life-threatening. However, if you have any concerns or questions about your heart rate, it is always best to see a doctor for a full examination to make sure there is no serious health problem.
Although PSVT doesn't always require treatment, there are treatments available if you need them. By staying active, limiting things like caffeine and alcohol, following a healthy lifestyle, and seeing your cardiologist on time, you can reduce your risk of complications from PSVT. So, take care of your heart, because it's your lifeblood!
` Heart palpitations, rapid heartbeat, PSVT, Paroxysmal Supraventricular Tachycardia, arrhythmia, heart disease, chest pain, tachycardia
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