PAROXISMAL SUPRAVENTRICULAR TACHYCARDIA AND PREGNANCY (SHORT REVIEW AND CLINICAL CASE)

Abstract

The case of a 24 year old primigravida at 37 weeks’ gestation with paroxysmal supraventricular tachycardia (Svt) and preterm labour is reported. She complained of palpitations, presyncopes, and syncopes at the age of 21. Long term cardiomonitoring was performed. During periods of sinus rhythm a transient Av block with pauses of more than 2-3 seconds was detected. It was associated with the development of at least one syncopal episode. In addition, rare (2-3 times per month) short (about 30 sec) periodes of Svt with heart rates 190-222 bpm, palpitations and presyncopes were detected. Symptoms disappeared without treatment after six months and recurred with the onset of pregnancy. Second holter monitoring confirmed only Svt. Vagal maneuvers were always effective. Normal delivery was planned. However preterm labour was managed by cesarean section under epidural anesthesia and with possibilities for temporary pacemaker replacement or antiarrhythmic drugs medication. Female baby was delivered of birth weight 3,33 kg with Apgar score of 9/10. Management of pregnancy in patients with a combination of Svt and Av block is discussed.