SUPRAVENRİKÜLER TAŞİKARDİSİ OLAN HASTALARA KLİNİK YAKLAŞIM
Supraventriküler taşikardi toplumda özellikle genç ve sağlıklı bireylerde gözükmektedir. Hastalarda semptomlar hafif bir çarpıntı hissi, baş dönmesi, göğüs ağrısı ve nefes dar- lığından; ciddi nefes darlığı, göğüs ağrısı, senkop, bilinç bulanıklığını içeren ciddi semp- tomlar arasında değişebilmektedir. Hastalardaki semptomlar ve tedavi supraventriküler taşikardinin tipine, süresine, atak sayısına ve eşlik eden hastalık durumuna göre değişir. Supraventriküler taşikardi ile başvuran hastalara ilk yaklaşım, hastanın başvuru sırasın- da hemodinamik olarak stabil olup olmamasına göre değişir. Bilinç düzeyinde bozulma, hipotansiyon ve ciddi nefes darlığı olan hastalarda acil elektriksel kardiyoversiyon uygu- lanmalıdır. Uzun dönem tedavide ise bu hastalarda farmakolojik veya kateter ablasyon tedavisi uygulanır. Kateter ablasyonu son zamanlarda gittikçe artan, komplikasyon oranı az ve başarı oranı yüksek bir tedavi şekli olarak karşımıza çıkmaktadır.
Clinical Approach to Patients with Supraventriculer Tachycardia
Supraventriculer tachycardia especially is seen in healthy young patients. Symptoms of patients are changing from mild symptoms including mild palpitation, dyspnea, dizziness to severe symptoms including severe chest pain, dyspnea, congestive heart failure, syncope, deterioration of consciousness. Treatment and symptoms are depended on the type of supraventriculer tachycardia, duration and numbers of attack of supraventriculer tachycardia and underlying heart disease. The first approach to patient with SVT is to consider whether these patients are stable or have hemodynamic deterioration. Patients with SVT who have hypotension, severe dyspnea, impairing in consciousness should be imme¬diately restored to sinus rhythm with electrocardioversion. In long term management, pharmacological or catheter ablation therapy are applied. Recently, using of the catheter theraphy is increasing due to high successive and lower complication ratio.
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