Cardiac dysrhythmia without pulsation, specifically ventricular tachycardia: Recognizing symptoms, determining causes, and pursuing treatment options
Pulseless ventricular tachycardia (VT) is a medical emergency that occurs when the heart does not pump enough oxygenated blood into the organs, including the heart itself. This irregular heartbeat, which is stemming from the ventricles, can be life-threatening if not treated promptly.
Symptoms of pulseless VT may include heart palpitations, shortness of breath, chest pain, fainting, and cardiac arrest. It's essential to seek immediate medical attention if these symptoms are experienced. Delaying treatment for as little as 15 minutes can significantly reduce the survival rate to just 5%.
Pulseless VT can be caused by various factors, including structural heart diseases such as coronary artery disease, congestive heart failure, aortic stenosis, cardiomyopathy, and myocardial infarction. Electrolyte imbalances, particularly hypokalemia, hyperkalemia, hypomagnesemia, and hypocalcemia, can also lead to pulseless VT. Other conditions that may cause pulseless VT include seizures, electrocution, and drug overdose, with certain drugs like clarithromycin, haloperidol, methadone, antiemetics, and antiarrhythmics being potential culprits.
Preventive measures focus on managing and mitigating these risk factors. Controlling underlying heart disease through lifestyle changes, medications, and interventions such as coronary revascularization (PCI) is crucial. Regular monitoring and correction of electrolyte imbalances are also vital to maintain normal cardiac conduction.
Avoidance or careful use of medications known to provoke arrhythmias is advisable. Lifestyle modifications such as limiting excessive alcohol, caffeine, smoking, and managing stress can reduce arrhythmia triggers. The use of implantable cardioverter-defibrillators (ICDs) in high-risk patients with a history of VT or significant cardiac damage can prevent sudden death from pulseless VT.
Early recognition and prompt treatment of symptoms indicating arrhythmia or cardiac ischemia are crucial. Public awareness and the availability of Automated External Defibrillators (AEDs) can significantly improve survival if pulseless VT occurs outside a hospital setting, where the survival rate is currently around 39.3%.
In the treatment process for pulseless VT, cardiopulmonary resuscitation (CPR) is performed, and a defibrillator is used to lower the person's heart rate with electric shocks. After the third defibrillation shock, 1 milligram (mg) of adrenaline and 300 mg of amiodarone are injected. If necessary, after the fifth defibrillation shock, 150 mg of amiodarone is administered.
It's important to note that pulseless VT, like ventricular fibrillation (VF), is a shockable rhythm. The use of a defibrillator by a bystander can improve the survival rate of someone who experiences pulseless VT outside of a hospital.
In summary, pulseless ventricular tachycardia mainly arises from structural heart disease and electrical disturbances caused by ischemia, electrolyte abnormalities, or genetic conditions. Prevention rests on managing these clinical factors, avoiding triggers, and employing medical devices where appropriate to prevent fatal arrhythmias.
- Structural heart diseases such as coronary artery disease, congestive heart failure, aortic stenosis, cardiomyopathy, and myocardial infarction, as well as electrolyte imbalances and genetic conditions, can cause arrhythmia heartbeat disorders like pulseless ventricular tachycardia.
- Achieving optimal health-and-wellness and maintaining cardiovascular-health is crucial in minimizing the risk of developing life-threatening medical-conditions like pulseless ventricular tachycardia.
- Science and medical advancements have provided solutions like implantable cardioverter-defibrillators (ICDs) that help manage heartvalvedisorders and prevent sudden death from arrhythmias like pulseless ventricular tachycardia in high-risk patients.
