A Recurrent Paroxysmal Supraventricular Tachycardia in Pregnancy
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Abstract
Introduction: Paroxysmal supraventricular tachycardia (PSVT) represents a subset of supraventricular tachycardia characterized by regular tachycardia rhythm with abrupt onset and termination. To date, there are no evidence-based guidelines for the management of PSVT in pregnancy. Its early diagnosis and prompt management are required to prevent adverse maternal and foetal outcomes.
Case description: A 21year old, G2P1L1 36.5 week, previous lower segment cesarean section (LSCS) with a known case of PSVT in a previous pregnancy, presented with dyspnoea. Diagnosis of PSVT was confirmed on 12 lead ECGs, with a 2D echo showing no structural or functional abnormalities. This patient was managed with a combination of various treatment options like carotid sinus massage, and anti-arrhythmic drugs (adenosine, diltiazem, metoprolol) to reverse and maintain the sinus rhythm. Elective LSCS was performed under spinal anaesthesia with good maternal & foetal outcomes.
Discussions: A patient with a known case of PSVT presented in 3rd trimester with an acute episode of PSVT. Pregnancy can precipitate new-onset paroxysmal supraventricular tachycardia in patients with or without underlying heart disease.
Conclusion: To achieve good foetal & maternal outcomes in cases of PSVT in pregnancy, requires a tertiary care centre with a multidisciplinary approach.
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References
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