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7h: Symptomatic Tachycardia (2025)
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This lesson covers how to care for symptomatic tachycardia. This type of tachycardia refers to a heart rate greater than 100 beats per minute. This in-depth lesson explains how to assess an individual according to which symptoms are being experienced.
Symptomatic tachycardia refers to heart rate greater than 150 beats per minute. To provide care for symptomatic tachycardia, follow these steps. However, if at any point you become uncertain or uncomfortable during the treatment of a stable individual, seek expert consultation. The treatment of stable individuals can be potentially harmful. Also, keep in mind that adenosine may cause bronchospasm; therefore, adenosine should be given with caution to patients with asthma.
If the individual is unstable, provide immediate synchronized cardioversion. Check if the tachycardia is producing hemodynamic instability and serious symptoms. Check if the symptoms, such as pain and distress of an acute myocardial infarction, or AMI are producing the tachycardia.
Assess the individual’s hemodynamic status by establishing an Iv, giving supplementary oxygen, and monitoring the heart. Heart rate of 100 to 130 beats per minute is usually the result of underlying process and often represents sinus tachycardia, in which the goal is to identify and treat the underlying systemic cause. Heart rate greater than 150 beats per minute may be symptomatic; the higher the rate, the more likely the symptoms are due to the tachycardia.
Assess the QRS complex, which includes regular narrow complex tachycardia (or probable SVT), irregular narrow complex tachycardia (or probable A-Fib), regular wide complex tachycardia (or probable VT), and irregular wide complex tachycardia.
To assess regular narrow complex tachycardia (or probable SVT), attempt vagal maneuvers. Obtain 12-lead ECG and consider expert consultation. Administer 6 mg of adenosine via rapid IVP; if there is no conversion, give 12 mg IVP as a second dose. You may attempt 12 mg only once.
To assess irregular narrow complex tachycardia (or probable A-Fib), obtain 12-lead ECG, and consider expert consultation. Control rate with diltiazem at 15 to 20 mg (that is 0.25mg/kg) intravenously over two minutes or beta-blockers.
To assess regular wide complex tachycardia (or probable VT), obtain 12-lead ECG, and consider expert consultation. Convert rhythm using amiodarone 150 mg intravenously over 10 minutes, and perform elective cardioversion.
To assess irregular wide complex tachycardia, obtain 12-lead ECG, and consider expert consultation. Consider anti-arrhythmic. If it is Torsades de pointes, give magnesium sulfate 1 to 2 gm intravenously; You may follow with 0.5 to 1 gm over 60 minutes.
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Symptomatic tachycardia refers to heart rate greater than 150 beats per minute. To provide care for symptomatic tachycardia, follow these steps. However, if at any point you become uncertain or uncomfortable during the treatment of a stable individual, seek expert consultation. The treatment of stable individuals can be potentially harmful. Also, keep in mind that adenosine may cause bronchospasm; therefore, adenosine should be given with caution to patients with asthma.
If the individual is unstable, provide immediate synchronized cardioversion. Check if the tachycardia is producing hemodynamic instability and serious symptoms. Check if the symptoms, such as pain and distress of an acute myocardial infarction, or AMI are producing the tachycardia.
Assess the individual’s hemodynamic status by establishing an Iv, giving supplementary oxygen, and monitoring the heart. Heart rate of 100 to 130 beats per minute is usually the result of underlying process and often represents sinus tachycardia, in which the goal is to identify and treat the underlying systemic cause. Heart rate greater than 150 beats per minute may be symptomatic; the higher the rate, the more likely the symptoms are due to the tachycardia.
Assess the QRS complex, which includes regular narrow complex tachycardia (or probable SVT), irregular narrow complex tachycardia (or probable A-Fib), regular wide complex tachycardia (or probable VT), and irregular wide complex tachycardia.
To assess regular narrow complex tachycardia (or probable SVT), attempt vagal maneuvers. Obtain 12-lead ECG and consider expert consultation. Administer 6 mg of adenosine via rapid IVP; if there is no conversion, give 12 mg IVP as a second dose. You may attempt 12 mg only once.
To assess irregular narrow complex tachycardia (or probable A-Fib), obtain 12-lead ECG, and consider expert consultation. Control rate with diltiazem at 15 to 20 mg (that is 0.25mg/kg) intravenously over two minutes or beta-blockers.
To assess regular wide complex tachycardia (or probable VT), obtain 12-lead ECG, and consider expert consultation. Convert rhythm using amiodarone 150 mg intravenously over 10 minutes, and perform elective cardioversion.
To assess irregular wide complex tachycardia, obtain 12-lead ECG, and consider expert consultation. Consider anti-arrhythmic. If it is Torsades de pointes, give magnesium sulfate 1 to 2 gm intravenously; You may follow with 0.5 to 1 gm over 60 minutes.
**************************************
Follow us on social media!
Together, let’s save lives.
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