Ventricular tachycardia physical examination


 * Associate Editor-in Chief: Avirup Guha, M.B.B.S.[mailto:avirup.guha@gmail.com]

Physical Examination

 * Physical findings depend in part on the P-to-QRS relationship with/without signs of AV dissociation are absent.


 * AV dissociation is present, although not always evident, in approximately 20% to 50% of patients with VT.


 * Intermittent cannon A waves can be observed on examination of the jugular pulsation in the neck, and they reflect simultaneous atrial and ventricular contraction.


 * Highly inconsistent fluctuations in the blood pressure can occur because of the variability in the degree of left atrial (LA) contribution to LV filling, stroke volume, and cardiac output.


 * Variability in the occurrence and intensity of heart sounds (especially S1) may also be observed and is heard more frequently when the rate of the tachycardia is slower.


 * VTs are generally unaffected by carotid sinus massage, although this maneuver may slow the atrial rate and, in some cases, expose AV dissociation.


 * Look for evidence of preexisting conditions like a pacemaker/AICD or scar mark from previous cardiothoracic surgery.