Paroxysmal Supraventricular Tachycardia Disease (PSVT) is a condition that usually affects young adults. It is characterized by a heartbeat that becomes very rapid and then returns to normal after a few seconds or minutes. This rapid heart rate occurs sporadically, which makes the disorder difficult to diagnose. PSVT is sometimes misdiagnosed as panic disorder or panic attacks.

What causes PSVT?

Risk factors include smoking, caffeine, and alcohol use. PSVT can also be associated with digitalis toxicity. It can be a form of a re-entry tachycardia, resembling Wolff-Parkinson-White syndrome.

What are the symptoms of PSVT?

• palpitations (a sensation of feeling the heart beat)
• rapid pulse
• anxiety, feeling of impending doom
• shortness of breath
• chest tightness
• fainting
• dizziness
• pale color

How is PSVT diagnosed?

During a PSVT episode, your heart rate may be 150 - 250 beats per minute.
Between episodes of PSVT, the heart rate is normal (60 to 100). There may be signs of poor perfusion.

Some tests that might be used to help diagose PSVT include:

• ECG during symptoms shows PSVT.
• Continuous ambulatory monitoring
• 24-hour Holter monitor

How is PSVT treated?

PSVT sometimes resolves itself without treatment.

People with mild symptoms can try a procedure known as a "Valsalva" maneuver to interrupt the PSVT episode. A valsava is accomplished by holding your breath and straining or coughing while sitting with the upper body bent forward.

Carotid artery massage is sometimes used to interrupt the episode. IMPORTANT: Carotid massage should only be accomplished by a health care provider skilled in its use. Carotid massage can cause severe slowing of the heart rate.

Electrical cardioversion (shock) is sometimes used.

Medications are sometimes used to treat the PSVT. These medications include verapamil, adenosine, esmolol, tensilon, phenylephrine, digoxin, procainamide, or others.

Pacemakers are sometimes used to override the "tachycardia" associated with PSVT.

Surgery to modify the conduction of the eletrical pulse that controls the impulse to contract in the heart is used in some cases. Radiofrequency ablation is a catheter-based technique sometimes used to treat PSVT.