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陣發性室上性心搏過速

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陣發性室上性心搏過速
又称Supraventricular tachycardia, paroxysmal atrial tachycardia (PAT)[1]
Lead II electrocardiogram strip showing PSVT with a heart rate of about 180.
症状Palpitations, feeling lightheaded, sweating, shortness of breath, chest pain[2]
起病年龄Starts and stops suddenly[3]
病因Not known[3]
风险因素Alcohol, caffeine, nicotine, psychological stress, Wolff-Parkinson-White syndrome[3]
診斷方法Electrocardiogram[3]
預防Catheter ablation[3]
治療Valsalva maneuver, adenosine, calcium channel blockers, synchronized cardioversion[4]
预后Generally good[3]
患病率2.3 per 1000 people[5]
分类和外部资源
醫學專科急診醫學心臟學
MedlinePlus000183
eMedicine156670
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陣發性室上性心搏過速(英語:Paroxysmal supraventricular tachycardia,簡稱 PSVT室上性心搏過速中的一種[6]。一般患者不會出現症狀[1],若有則可能是心悸、頭重腳輕、盜汗、呼吸困难胸痛[2],症狀出現得快,也消失得快[3]

病因尚屬未知[3],風險因子有酒精、咖啡因尼古丁心理壓力及遺傳得來的沃夫巴金森懷特症候群[3]。此疾病的機制和副传导路径英语accessory pathway有關,會造成進入錯誤迴路(英語:re-entry)的心律不整[3]。診斷會藉由心电图(英語:ECG)來進行,若有窄QRS波群英语narrow QRS complexes且心律較快,在每分鐘150至240下之間,即可確診為陣發性室上性心搏過速[3]

常見的初步治療為採用迷走神經刺激術英语Vagal maneuver,例如持續閉氣用力英语Valsalva maneuver(又稱伐氏操作),如果不見效且患者血壓正常,可能會採用腺苷;如果腺苷沒有幫助,可能會採用鈣離子通道阻滯劑β受體阻滯劑;或者會改採心率調整來治療[4]。預防之後發作的方法是心導管燒灼術英语Catheter ablation[3]

在每千人中約有2.3人患有陣發性室上性心搏過速[5],通常發病於12~45歲[3][5],女性患者較男性患者為多[3]心臟健全者的治療成效往往也很好[3]。在釐清心臟病症時,可能會藉由心臟超音波來做判斷[1]

註釋

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  1. ^ 1.0 1.1 1.2 Ferri, Fred F. Ferri's Clinical Advisor 2013,5 Books in 1, Expert Consult - Online and Print,1: Ferri's Clinical Advisor 2013. Elsevier Health Sciences. 2012: 807. ISBN 978-0323083737. (原始内容存档于2016-10-02) (英语). 
  2. ^ 2.0 2.1 What Are the Signs and Symptoms of an Arrhythmia?. NHLBI. July 1, 2011 [27 September 2016]. (原始内容存档于2015-02-19). 
  3. ^ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 Al-Zaiti, SS; Magdic, KS. Paroxysmal Supraventricular Tachycardia: Pathophysiology, Diagnosis, and Management.. Critical Care Nursing Clinics of North America. September 2016, 28 (3): 309–16. PMID 27484659. doi:10.1016/j.cnc.2016.04.005. 
  4. ^ 4.0 4.1 Neumar, RW; Shuster, M; Callaway, CW; Gent, LM; Atkins, DL; Bhanji, F; Brooks, SC; de Caen, AR; Donnino, MW; Ferrer, JM; Kleinman, ME; Kronick, SL; Lavonas, EJ; Link, MS; Mancini, ME; Morrison, LJ; O'Connor, RE; Samson, RA; Schexnayder, SM; Singletary, EM; Sinz, EH; Travers, AH; Wyckoff, MH; Hazinski, MF. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.. Circulation. 3 November 2015, 132 (18 Suppl 2): S315–67. PMID 26472989. doi:10.1161/cir.0000000000000252. 
  5. ^ 5.0 5.1 5.2 Katritsis, Demosthenes G.; Camm, A. John; Gersh, Bernard J. Clinical Cardiology: Current Practice Guidelines. Oxford University Press. 2016: 538. ISBN 9780198733324. (原始内容存档于2016-10-02) (英语). 
  6. ^ Types of Arrhythmia. NHLBI. July 1, 2011 [2017-08-08]. (原始内容存档于2015-06-07). 

參閱

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外部連結

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