![]() Ī recent study of commercial and Medicare insurance claims covering over 18 million adults from 2008 to 2016 reported that about 67% of identified patients with PSVT were female period prevalence increases with age in both sexes up to 84 years. 1,2 Unlike ventricular tachycardia, PSVT is usually a benign and self-limited arrhythmia, although in rare circumstances it can be associated with an extremely rapid and life-threatening heart rhythm. Estimated annual population incidence of PSVT, as reported in the peer-reviewed literature, ranges from 9.5 to 97 per 10,000 persons, depending on age and sex, with the highest prevalence in persons over 65 years of age. Paroxysmal supraventricular tachycardia (PSVT) is very common. The symptom of palpitation may be caused or associated with a number of underlying physiologic states or disorders as outlined in the table below. Palpitations may be felt in the chest, upper abdomen or neck. ![]() The symptom may be very brief such as may occur with premature beats or sustained, with or without a sensation of tachycardia. This sensation is described by patients in a variety of ways such as a forceful or irregular heartbeat, a rapid or flip-flopping sensation. However, the symptom of palpitation is common and may be defined as an abnormal awareness of the heart beating. The adult human heart beats approximately 100,000 times every day and conscious awareness of the heart beating is not normal. She was relieved to be “finally diagnosed” as having paroxysmal supraventricular tachycardia (PSVT) after more than two decades of experiencing these symptoms.īy David T. However, at 9 minutes, she began to experience one of her “woozy” spells and the ECG showed a regular heart rate of 230 beats per minute with narrow QRS complexes. The ECG was normal and she was referred for a cardiac exercise treadmill test, which was normal for the first 8 minutes. The physician reluctantly ordered a 24-hour Holter monitor, which came back “normal,” although she did not have any symptoms while wearing the monitor.Īt the age of 40, the patient had another severe episode during which she felt a twinge of chest pain, and again went to an ED. Based on her internet reading, she asked if this could be a heart rhythm problem. After this attack, she scheduled a primary care appointment.Īfter taking her social history, the physician suggested that she see a psychiatrist for presumed panic attacks. Two years later, the symptoms occurred while on a bicycle ride, requiring her to dismount and sit on the side of the road for 45 minutes until the symptoms subsided. At a time when she was feeling particularly stressed, she experienced a more severe episode that she described as “her heart pounding.” She went to a local emergency department (ED) thinking she might be having “a heart attack.” She had a normal electrocardiogram (ECG) and was discharged with a diagnosis of “likely stress reaction/possible panic attack.” She felt embarrassed for having gone to the ED and although she continued to periodically have these symptoms, she did not mention them to anyone. When the patient was in her 30’s, she went through a period of significant emotional and financial stress, having just broken up with her longtime boyfriend, and suffered some loss of income. ![]() Over the ensuing years, similar episodes occurred occasionally, usually related to stress, such as while giving presentations to large audiences. There was no family history of heart disease. The symptoms lasted between 5 and 15 minutes, and then subsided after sitting down. Her symptoms were abrupt in onset and she felt her heart was racing and pounding like it was going to jump out of her chest. She described it as “not a black-out but a feeling of a white-out” occurring roughly once every month or two. At the age of 16, an otherwise healthy woman began feeling “woozy” after her high school gym classes.
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