Contents

Search


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

  1. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 141
  2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 271
  3. Medical Knowledge Self Assessment Program (MKSAP) 18, 19. American College of Physicians, Philadelphia 2018, 2022