A CLINICAL AND ELECTROCARDIOGRAPHIC STUDY OF PAROXYSMAL VENTRICULAR TACHYCARDIA AND ITS MANAGEMENT

Abstract

Twenty cases of paroxysmal ventricular tachycardia are analyzed as to underlying heart disease, symptoms, and response to various methods of treatment. Diagnosis in each case was made by Ecg. Acute myocardial infarction or digitalis toxicity was present in 15 of the patients, but 2 cases occurred in patients with apparently normal hearts. Although early termination is necessary to avoid serious complications, the underlying myocardial damage is frequently so severe that life may be prolonged only for a short time. Oral quinidine, intraven. quini-dine, and intraven. morphine were used with success. The necessity for maintenance dosages of quinidine or K to prevent recurrences is stressed. Toxic drug reactions and prolongation of the QRS more than 25% only rarely prevent the proper dosage of quinidine or K salts. Morphine intraven. is the most innocuous and doses up to 65 mg. should be tried first in cases of paroxysmal ventricular tachycardia.