Oth the fast along with the slow pathways. Electrocardiogram (ECG) ordinarily indicates the absence of a P wave preceding the QRS complex; the P wave can appear as a pseudo R’ wave in lead V1 and pseudo S’ in the inferior leads. Acute termination is by means of physical maneuvers (vagal stimulus) or adenosine. Treatment preventing recurrent AVNRT involves AV nodal blocking therapy with B blockers or nondihydropyridine calcium channel blockers. If frequent AVNRT continues or the patient prefers to avoid long-term healthcare therapy, catheter ablation is warranted, which carries a 1 threat of AV nodal injury requiring pacemaker implantation [8].Case PresentationThe patient can be a 33-year-old female using a reported history of depression for any duration of one month, who presented with recurrent episodes of palpitations soon after a evening of salsa dancing. The patient reported current feelings of depression attributed to marriage issues. The patient started seeing a psychotherapist specialized in marriage counseling three weeks before presentation, who recommended the usage of St. John’s wort at a dose of 300 mg each day. 3 weeks post-initiation of pharmacologic therapy, the patient reportedHow to cite this article Fisher K A, Patel P, Abualula S, et al. (April 07, 2021) St. John’s Wort-Induced Supraventricular Tachycardia. Cureus 13(4): e14356. DOI 10.7759/cureus.sweating, insomnia, and frequent episodes of palpitations both at rest and with exertion, which exhibited persistence of much less than one minute with spontaneous resolution. At presentation, the patient was awake, alert, and oriented, with a palpable carotid pulse and heart rate (HR) of 150-160. The patient denied chest discomfort, shortness of breath, dizziness, or presyncopal symptoms. On web page, a Valsalva and carotid artery massage was performed simultaneously, with resultant acute abruption of tachycardia. Upon arrival for the emergency department (ED), yet another episode occurred with comparable presentation (HR: 150-160 bpm; blood pressure (BP): 110/68 mmHg; oxygen saturation and respiratory price within standard limits; denied chest discomfort, shortness of breath, or presyncopal symptoms). ECG revealed SVT with HR 148 bpm, with no preceding P wave, pseudo R’ on V1, and pseudo deep S’ in the inferior leads. Physical exam was deemed unremarkable, aside from tachycardia and reported anxiousness, which the patient attributed to the palpitations. All laboratory findings were inside standard limits, including total blood count (CBC) and comprehensive metabolic panel (CMP), with adverse toxicology screen, undetectable blood alcohol level, and troponin x1. The patient received lorazepam 1 mg IV. Right after 5 minutes of attempted Valsalva maneuver, the rhythm converted to sinus rhythm (SR) without the need of the administration of adenosine. The patient was discharged residence from the ED, having a scheduled electrophysiologist (EP) outpatient follow-up. Upon EP follow-up, HD2 Source repeat electrolytes were normal, using a transthoracic echocardiogram (TTE) revealing normal ejection fraction (EF) at 60-65 , no wall motion abnormality, regular cardiac valves, regular cardiac structures, and dimension with appropriate ventricular systolic stress (RVSP) 26. Recommendations integrated quick discontinuation of St. John’s wort herbal supplement, with strict observation and no health-related or invasive interventions deemed D5 Receptor Synonyms important. The patient continued to report episodes of palpitations, persisting anyplace from 30 seconds to five minutes, with either resolution spontaneously or wit.