Supraventricular Tachycardia Associated With Repeat Cesarean Section Under Spinal Anesthesia

Area of Science:

• Cardiology
• Obstetrics
• Maternal-Fetal Medicine

Background:

• Supraventricular tachycardia (SVT) is the most frequent tachyarrhythmia during pregnancy.
• Pregnancy-associated factors like catecholamine surges and increased cardiac output contribute to SVT development.

Observation:

• SVT symptoms include palpitations, syncope, shortness of breath, chest pain, dizziness, and sweating.
• Organic heart conditions must be ruled out upon SVT detection, especially in patients with rheumatic heart disease and mitral stenosis.

Findings:

• Hemodynamically unstable patients refractory to pharmacologic management benefit from safe and efficacious electrical cardioversion across all trimesters.
• For hemodynamically stable patients, initial treatment involves vagal maneuvers, followed by adenosine or beta-blockers if unsuccessful.
• Atenolol and verapamil are contraindicated due to potential teratogenic effects.

Implications:

• Prompt diagnosis and appropriate management of SVT are crucial for maternal and fetal well-being during pregnancy.
• Understanding SVT's common causes and safe treatment options is vital for obstetric and cardiology providers.
• Avoiding specific teratogenic medications ensures optimal outcomes for pregnant patients experiencing SVT.