Maybe you or someone you know was recently diagnosed with paroxysmal atrial tachycardia (PAT), also known as paroxysmal supraventricular tachycardia (PSVT). The easiest way to demystify many seemingly complex medical conditions is to break them down into simpler parts, and it works to understand almost all conditions. Paroxysmal is medical jargon for sudden episode. The atrium is a region of your heart above the ventricle that is also involved with pumping blood, and tachycardia refers to a faster than normal heart beat. Put together you have a sudden burst of rapid beating in a portion of your heart.
Now that we have a better understanding what we are talking about, what causes this syndrome?
The heart is able to pump blood because of a pattern of electrical impulses that spread through the muscle causing it to contract, and in doing so moves blood through forward through the vascular system to the brain, kidneys, liver, skin, and other vital organs. The sinoatrial (SA) node found in the atrium normally acts as a pacemaker in the heart, initiating the signal which tells the rest of the heart muscle to squeeze. Blood first enters the atria, which contract, pushing the blood to the ventricles. The ventricles contract shortly after they are filled by the atria and circulate blood throughout the body or the lungs, depending what side of the heart you are looking at. PAT/PSVT comes from an abnormal electrical signal in the atrium that causes the atria to contract more quickly and speeds up the heart rate. The signal may be too fast for the heart to properly fill with blood before pumping, and this can decrease the supply of blood to the whole body.
It sounds pretty scary, what are the symptoms?
Some people may not have any symptoms, others may notice:
-feeling chest pain (also known as angina)
-feeling shortness of breath
-feeling rapid heartbeats or “palpitations”
-In rare cases patients may also lose consciousness or have cardiac arrest
How is it diagnosed?
Your doctor will ask you some questions and run some painless tests to look at the electrical conduction of your heart. Typically testing may start with an electrocardiogram (EKG/ECG) which consists of sticky pads which attach to your chest. You will not feel the electricity and most people report removing the sticky pads is the most uncomfortable part of the test. You may also have an ultrasound or other images taken of your heart or be asked to wear a monitor for a day to track the electrical signals in your heart over time.
How is it treated?
Your doctor will talk to you about your options, and many people don’t need treatment for the paroxysmal form of atrial tachycardia. The best things you can do to help yourself include:
Decreasing your coffee/caffeine intake
Decreasing your alcohol
Improve your stress management skills
Get more sleep
Your doctor may also try techniques such as carotid sinus massage or have you perform a Valsalva maneuver to stop an episode of tachycardia; however these should be attempted by a doctor and should be supervised to minimize risks such as heart, brain, or lung injury.
Some people who have a persistent condition may need medications or a medical procedure called ablation which helps to slow the overactive pacemaker in the heart.
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