Permanent junctional reciprocating tachycardia

In a nutshell

Permanent junctional reciprocating tachycardia (PJRT) is a rare cardiac arrhythmia. It is a supraventricular tachycardia, and a cause of atrioventricular reentrant tachycardia (AVRT). PJRT can cause chronic tachycardia that, untreated, leads to cardiomyopathy. The cause is an accessory pathway in the heart which conducts from the ventricles back to the atria. Unlike the accessory pathway in a more common cause of AVRT, Wolff–Parkinson–White syndrome, the accessory pathway in PJRT conducts slowly. This means that the associated tachycardia may be subclinical and only diagnosed at a late stage, after significant damage to the heart has been caused from prolonged and recurrent episodes of AVRT. While PJRT generally presents itself in infants, and often immediately after birth, few adults can suffer from a sudden onset of PJRT in which the degrading accessory pathway can more often than not be in a non-posteroseptal site.

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Symptoms

Palpitations during exercise or stress may be the presenting symptom. Because the initial symptoms are often mild, there may be significant myocardial damage at the time of diagnosis. It is therefore possible for these patients to present with the symptoms of heart failure, such as shortness of breath, fatigue and oedema (fluid retention).

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Permanent junctional reciprocating tachycardia

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Cause

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