Stavros Sarah, Pinon Ana M, Gates Kevin, Khamvongsa Peter
Obstetrics and Gynecology, Florida International University (FIU) Herbert Wertheim College of Medicine, Miami, USA.
Cureus. 2022 Jun 29;14(6):e26425. doi: 10.7759/cureus.26425. eCollection 2022 Jun.
This report describes the clinical presentation and systematic workup of a 25-year-old primigravid woman presenting at 34 weeks gestation with symptoms of postprandial sinus tachycardia. Differentials included pregnancy-related inappropriate sinus tachycardia (PRIST) and swallowing-induced atrial tachycardia. PRIST has favorable outcomes for both the mother and baby, although the symptoms can be distressing and lead to the overutilization of healthcare resources. The literature describes symptom onset as sporadic with no definitive triggers, often occurring in the later trimesters of pregnancy. Swallowing-induced atrial tachycardia, which fits with postprandial symptoms seen in this patient, is a distinct entity most commonly diagnosed in middle-aged men. Management included psychosocial support and pharmacologic treatment with labetalol. The patient's course was benign with an uncomplicated delivery at 38 weeks, complete resolution of symptoms in the postpartum period, and successful discontinuation of pharmacologic management with no relapses. Current literature on postprandial sinus tachycardia in pregnant women is limited, and the best treatment method is unknown. This report extends current knowledge on pregnancy-related postprandial sinus tachycardia and provides a framework for advances in the management of this clinical presentation.
本报告描述了一名25岁初孕妇的临床表现及系统检查情况，该孕妇在妊娠34周时出现餐后窦性心动过速症状。鉴别诊断包括妊娠相关的不适当窦性心动过速（PRIST）和吞咽诱发的房性心动过速。PRIST对母婴均有良好预后，尽管症状可能令人痛苦并导致医疗资源的过度使用。文献将症状发作描述为散发性，无明确诱因，常发生在妊娠晚期。吞咽诱发的房性心动过速与该患者的餐后症状相符，是一种最常见于中年男性的独特病症。治疗措施包括心理社会支持和使用拉贝洛尔进行药物治疗。患者病程顺利，38周时顺产，产后症状完全缓解，成功停用药物治疗且未复发。目前关于孕妇餐后窦性心动过速的文献有限，最佳治疗方法尚不清楚。本报告扩展了关于妊娠相关餐后窦性心动过速的现有知识，并为该临床表现的管理进展提供了一个框架。
