Tachycardia Evaluation and its Management Approach, Literature Review

Tachycardia is a term used to describe any abnormally elevated heart rate exceeding or equal to 100 beats per minute (bpm), it can occur as the result of a wide array of pathologies. The majority of patients are symptomatic and typically present complaining of palpitations or chest discomfort. Patients may also have more dreadful presentations such as shock, hypotension, dyspnea, altered conscious level, myocardial infarction, and heart failure. Tachycardias are classically classified into narrow complex tachycardia (NCT) and wide complex tachycardia (WCT) based on the width of the QRS complex on Electrocardiography (ECG). Our objective was to look into the literature concerning the different types of tachycardia and their diagnosis along with their management. PubMed database was used for articles selection, papers afterward were obtained and reviewed accordingly. Clinical presentations of tachycardia can vary from simple palpitations or lightheadedness to severe shock or even sudden death. Diagnosis is mainly through the use of ECG or Holter monitor. The first step in the management of any type of tachycardia is assessing the hemodynamic stability of the patient, where if they were found to be unstable prompt use of cardioversion is warranted to prevent progression into cardiac arrest. In cases of stable NCT vagal maneuvers and IV, adenosine is considered to be the initial line of the therapy, other treatment options include radiofrequency or catheter ablation.