What is ventricular tachycardia?
Ventricular tachycardia (VT) is a fast heart rhythm (more than 100 beats per minute, along with a minimum of 3 irregular heartbeats in a row), which begins in the lower chambers of the heart (ventricles). Worsening VT, if left untreated, leads to life-threatening conditions such as ventricular fibrillation and may lead to death.
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Symptoms of VT may start or stop abruptly. In some cases, no symptoms may be seen. The most common symptoms of VT observed during an episode include:
- Shortness of breath
- Chest discomfort also called angina
- Palpitations (where irregular or rapid heartbeats are felt, making the individual uncomfortable)
- Weak or no pulse
- Low blood pressure
- Light-headedness
- Dizziness
- Fainting (syncope)
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What are the main causes?
The various factors or conditions leading to VT include:
- Early or late complication of a heart attack
- Congenital heart defect
Inherited heart rhythm problems which include:
- Long QT syndrome
- Brugada syndrome
- Myocarditis
- Cardiomyopathy
- Hypertrophic
- Dilated
- Heart failure
- Heart surgery
- Valvular heart disease
- Scar tissue in the muscle of the ventricles (generally, after a heart attack)
Other non-cardiac causes of VT include:
Medications which include:
- Anti-arrhythmic drugs (used to treat an abnormal heart rhythm)
- Non-prescription decongestants
- Herbal remedies and diet pills
- Cocaine or other stimulants
- Changes in blood chemistry which include:
- Low potassium level
- Changes in acid-base balance
- Lack of oxygen
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How is it diagnosed?
The physician will take a complete history of symptoms, carry out a thorough physical examination and check the pulse and blood pressure. The physician may further advise the following tests:
- Blood tests which include blood chemistry, pH of blood and oxygen level in blood
- Chest X-ray
- Electrocardiogram (ECG) or Holter monitor (where 24-48 hour monitoring of heartbeat is required)
- Intracardiac electrophysiology study (EPS)
- Loop recorder or device to record rhythm
Management for VT depends on the type of heart disorder and the symptoms seen and includes:
Medications given through a vein during an episode or orally as long-term treatment include:
Treatment measures during an episode including:
- Cardiopulmonary resuscitation (CPR)
- Cardioversion (electric shock)
- Ablation: In which the heart tissue causing the abnormal heartbeat is destroyed.
- An implantable cardioverter defibrillator (ICD): An implanted device that detects any rapid heartbeat which is life-threatening and quickly signals the heart to change the rhythm back to normal by sending an electrical shock.
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