Supraventricular Tachycardia: Diagnosis, Treatment, and the Patient Journey

What is a Supraventricular Tachycardia?

Supraventricular Tachycardia, also known as SVT, is an umbrella term for an elevated heart rate of over 100 bpm that takes place in the atria. This rapid heart rate is due to issues in the heart’s electrical conduction system and is initiated by a premature atrial beat. Episodes start and stop without warning.

While SVT is relatively common and rarely life-threatening, the condition can significantly impact a patient’s life. Some patients experience mild symptoms and episodes that are infrequent and relatively short in duration; others face a multitude of symptoms and/or long-duration episodes that alter sleep, affect the ability to stay active and enjoy daily activities, affect work, lead to potential risk for injury if syncope is involved, and necessitate visits to the emergency department.

SVT Types

Most patients with SVT do not have underlying heart disease. While a patient’s episodes of SVT may be frequent, it may be difficult to definitively diagnose if their symptoms do not occcur while the patient is being monitored in the clinical setting. SVT is often misdiagnosed as panic or stress. An ECG or heart monitor may be used in diagnosis.

SVT can affect both children and adults; women are affected more than men. Individuals more likely to acquire this condition are those with anxiety, drink more alcohol than recommended, smoke or use tobacco, or ingest large quantities of caffeine.

  • PSVT: paroxysmal supraventricular tachycardia – Often affects young people who are training or exercising hard
  • AVNRT: atrioventricular nodal reentrant tachycardia – common in young adults and the elderly
  • Accessory pathway tachycardia (e.g., Wolff-Parkinson-White syndrome) – Common in those younger than 12
  • PACs: premature atrial contractions
  • Atrial tachycardia
  • Atrial fibrillation
  • Atrial flutter

Typical Symptoms

  • Very rapid pulse (>100 bpm)
  • Fluttering or pounding in the chest (palpitations)
  • Pounding sensation in the neck
  • Chest pressure or pain
  • Shortness of breath
  • Lightheadedness, dizziness
  • Syncope
  • Weakness or fatigue
  • Anxiety

Helping Patients on Their SVT Journey

Onset may occur at any time, and accurate diagnosis is critical to effective management and treatment throughout the patient’s lifespan.

Patients with SVT often need support and reassurance. The potential for an episode to happen at any time may increase a patient’s overall anxiety and impact their daily living. Encouragement from family, friends, and healthcare professionals can lead to greater confidence and feelings of well-being by patients.

Sharing information and experiences with other patients with SVT may help patients feel they are not alone but part of a community, encouraged by being able to learn from others and feel more positive overall.

Helping patients understand the disease and its management may lead to increased implementation of self-care and lifestyle modifications to help reduce symptoms and increase medication adherence.

Open communication between the patient and their healthcare team ensures that worsening symptoms or decreasing treatment effectiveness can be addressed promptly.

Clinical Takeaways

  1. Patient and provider awareness of SVT helps increase diagnosis and effective treatments.
    a. Symptom tracking by patients can be helpful in effective management
  2. A combination of lifestyle modifications, pharmacotherapies, and procedures may be used to treat SVT.
  3. Patients should know what symptoms should lead them to seek help in the Emergency Department or trigger a call to their healthcare team.

SVT Resources

PCNA has a series of informational resources for healthcare professionals and patients.

  • Video: PSVT Strikes Any Time, Any Place
    • Capturing a conversation between a health care professional (HCP) and a patient with SVT—who is also a nurse—this 11-minute video focuses on the patient’s journey.
    • Faculty: Cathy Scott-Lynch, RN, MSN, BSN, CCM, and Jessica Bumgarner, BSN-RN, CHFN
  • Podcast Episode: Episodic Rapid Heart Rates—PSVT, AFib, and More
    • Pathophysiology, prevalence, symptoms, and disparities related to diagnosis and treatments, and helpful resources for providers and patients
    • Faculty: Kathryn Wood, PhD, RN, FAHA, FAAN
  • Podcast Episode: Living with PSVT: A Patient-Centered Care Plan
    • Learn about the patient journey for those living with PSVT, including the challenges that can delay diagnosis, as well as the importance of patient-centered care in and beyond the healthcare setting
    • Faculty: Mary Janette Sendin, MSN, APRN-CNS, CCNS, PCCN, and patient Daniel Weinstein
  • Podcast Episode: Treatment for PSVT
    • A discussion of traditional pharmacologic and non-pharmacologic treatment options, plus research into additional treatments
    • Faculty: Mary Janette Sendin, MSN, APRN-CNS, CCNS, PCCN

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