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Diagnosis Dan Tatalaksana Awal SVT
Diagnosis Dan Tatalaksana Awal SVT
Diagnosis Dan Tatalaksana Awal SVT
1. Site of Origin
Atrium
SA Node • AET
• Sinus Node
• MAT
dysfunction • Atrial Fibrillation
• Sick Sinus Syndrome
• Atrial Flutter
• SA Nodal Reentry
tachycardia
AV Node/ Junctional
• AVRT
• ANVRT Ventricle
• Junctional • VT
Tachycardia • VF
• PJRT
Classification PEDIATRIC CARDIOLOGY UPDATE
2. Anatomical Classification
SVT
His Bundle
VT
Classification PEDIATRIC CARDIOLOGY UPDATE
3. Functional Mechanism
• Re-entry –
• AVRT, AVNRT
• Automaticity
• AF, AET,MAT
• Triggered activity
• rare
SVT PEDIATRIC CARDIOLOGY UPDATE
Poisoning
Metabolic disturbance
Cardiomyopathy
Long QT syndrome
Drugs
Myocarditis
Causes PEDIATRIC CARDIOLOGY UPDATE
History
Symptoms : tachycardia, dizziness, shortness of breath,
sweating, fainting or near fainting
Frequency and length of episode episodes
associated with exercise activity, caffeine
Onset and triggers
Any underlying disease
Medications
Triggering factor
Used for underlying cardiac disease
Red flags PEDIATRIC CARDIOLOGY UPDATE
Approach To SVT
Diagnosing Types of SVT PEDIATRIC CARDIOLOGY UPDATE
Retrograde p wave
Multiple p waves
SVT
PEDIATRIC CARDIOLOGY UPDATE
Narrow complex, absent p wave PEDIATRIC CARDIOLOGY UPDATE
Narrow complex, retrograde p wave PEDIATRIC CARDIOLOGY UPDATE
4. p wave relation to QRS? PEDIATRIC CARDIOLOGY UPDATE
-Atypical AVNRT
-PJRT
-Atrial tachycardia
-Sinus tachycardia
-sinus node tachycardia
Narrow Complex, Regular RR interval,
Long RP Tachycardia
PEDIATRIC CARDIOLOGY UPDATE
PEDIATRIC CARDIOLOGY UPDATE
Rate – 200bpm
QRS – narrow complex and regular R-R interval
P wave not visible
SVT - AVRT, AVNRT, atrial or juctional tachycardia
PEDIATRIC CARDIOLOGY UPDATE
Rate – 300bpm
QRS – narrow complex and regular R-R interval
P wave – visible and retrograde
Short RP tachycardia
Diagnosis : AVRT
PEDIATRIC CARDIOLOGY UPDATE
Rate – 200bpm
QRS – Narrow complex, regular R-R interval
P wave not easily seen
Pseudo r wave in V1 and pseudo s in II
Diagnosis : AVNRT
PEDIATRIC CARDIOLOGY UPDATE
ATRIAL FIBBRILATION
PEDIATRIC CARDIOLOGY UPDATE
• Narrow complex
• Regular R-R interval
• p wave seen, Long RP tachycardia
• Inverted p wave in II, III and aVF
1. Airway – secure
2. Breathing – oxygen
3. Circulation – check HR and presence of shock
• Valsalve maneuvere
• Synchronised cardioversion
Unstable
• Recurrent episode
2. Older children
- carotid massage
- Valsalva technique
Chronic SVT Prevention PEDIATRIC CARDIOLOGY UPDATE
1. No treatment
2. Anti Arrhythmic drug
1. - iv amiodarone
2. - iv verapamil
3. - digoxin
3. Radiofrequency ablation
Summary PEDIATRIC CARDIOLOGY UPDATE
Terima kasih
PERWAKILAN V
MALANG