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sinus tachycardia
Depolarization of the sinus node at a rate >100/min with a normal pattern of atrial & ventricular activation.
Etiology:
1) increased levels of circulating catecholamines -pheochromocytoma
2) pain
3) hypovolemia, anemia
4) hypoxemia
5) myocardial ischemia or myocardial infarction
6) pulmonary embolism
7) fever
8) inflammation
9) hyperthyroidism
10) anxiety [3]
11) exercise [3]
Clinical manifestations:
- may lead to decreased cardiac output
Special laboratory:
- electrocardiogram:
a) p-wave precedes each QRS complex
b) p-waves have normal configuration & axis
c) PR interval is normal or slightly shortened
d) QRS pattern is usually normal
e) occasionally, bundle-branch block may occur secondary to increased rate
Management:
1) correct underlying precipitating factors
2) fluid replacement in hypovolemic patient
3) beta-adrenergic receptor antagonist
a) volume repleted patient
b) myocardial ischemia or myocardial infarction
Specific
inappropriate sinus tachycardia
General
supraventricular tachycardia (SVT)
References
- Manual of Medical Therapeutics, 28th ed, Ewald &
McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 141
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 271
- Medical Knowledge Self Assessment Program (MKSAP) 18, 19.
American College of Physicians, Philadelphia 2018, 2022