PSVT is significant mainly for rapid heart rate. Prominent jugular venous pulsations due to atrial contraction against closed AV valves may be a clue to AVNRT. History, physical exam, and an ECG constitute an appropriate initial evaluation. Further diagnostic studies are indicated only if there are signs or symptoms that suggest structural heart disease. A 12-lead ECG during tachycardia is helpful for defining the mechanism of PSVT. In patients with brief, selfterminating episodes, an event recorder is the most effective way to obtain ECG documentation.2 Patients with panic disorder report symptoms similar to those of PSVT, and an ECG during palpitations aids in diagnosis.