SUPRAVENTRICULAR TACHYCARDIA WITH UNSTABLE HEMODYNAMIC

Eka Satrio Putra, Gunung Mahameru

RSUD Singaparna

INTRODUCTION CASE REPORT DISCUSSION

Rhythm, volume, and pump are three key points A 49 year old female Initial cardioversion dose needed to terminate
that needs to be approached in managing patient came to the SVT is 50-100 J which can be increased
hypotension. Supraventricular tachycardia emergency room with gradually. SVT will usually resolved after 1-2
(SVT) with unstable hemodynamic is a life difficulty of breathing, shocks are delivered [1-2]. In cardiogenic
threatening arrhythmia, therefore synchronized and palpitation. The shock management, problems related to
cardioversion is needed. patient had a history of pump needs to be addressed after rate
u n c o n t r o l l e d problem is resolved but no circulation
hypertension. Vital improvement is evident [3]. Fluid challenge
signs: blood pressure combined with inotropes should be given.
OBJECTIVE was 100/palpation, pulse was weak with poor extremities Dopamine is the main choice of inotropic until
perfusion, saturation was 90%. Electrocardiograph showed hypoperfusion signs decreases [4].
To conduct the management of SVT with
no P wave with regular narrow QRS complex at 203 bpm rate,
unstable hemodynamic.
thus showed SVT. Synchronized cardioversion was
performed with midazolam sedation. After initial 50 J shock,
CONCLUSION
rhythm still showed SVT. After second shock using 70 J, the
Keywords : Supraventricular Tachycardia, Cardioversion, Dopamine rhythm became sinus tachycardia. However, blood pressure SVT termination is performed using
showed no changes and she was still in cardiogenic shock, synchronized cardioversion, if there are still any
REFERENCE : therefore 200 cc saline and dopamine were given as signs of shock, then fluid challenge and
1. Mann D et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine 10 th
ed. 2014. New York: Saunders inotropes. inotropic is needed
2. Mackey DC et al. Morgan and Mikhail's Clinical Anesthesiology 5th ed. 2013. New York:
Lange.
3. Vincent JL et al. Textbook of Critical Care 7th ed. 2015. Philadelphia: Elsevier
4. Cline DM et al. Tintinalli's Emergency Manual 7th ed. 2014.New York: McGraw-Hill