Sinus tachycardia

Sinus tachycardia

Sinus tachycardia (ST) – increased heart rate at rest up to 90-130 per minute. With heavy physical exertion, the normal regular sinus rhythm increases to 150-160 per minute (in athletes – up to 200-220). Etiology – generation of excitatory impulses by the sinoatrial node with an increased frequency

• • Fever (an increase in body temperature by 1 ° C causes an increase in heart rate by 10 per minute)
  • Excitation (hypercatecholaminemia)
  • Hypercapnia
  • Physical exercises
  • Pain
  • Shock
  • Left ventricular failure
  • Cardiac tamponade
  • hypovolemia
  • drugs (adrenaline, ephedrine, atropine). Diseases most commonly associated with TS
  • Thyrotoxicosis
  • THEM
  • Endocarditis
  • Myocarditis
  • TELA
  • Anemia
  • Cardiopsychoneurosis
  • mitral stenosis
  • Aortic valve insufficiency
  • Pulmonary tuberculosis.

Clinical picture

• • Palpitations, feeling of heaviness, sometimes pain in the region of the heart
  • Symptoms of the underlying disease.

ECG identification

• • Heart rate at rest – 90-130 per minute
  • Each P wave corresponds to the QRS complex, the P-P intervals are equal to each other, but when combined with sinus arrhythmia, they can differ by more than 0.16 s
  • With severe ST, the P waves may merge with the T waves preceding them, simulating atrial or atrioventricular paroxysmal tachycardia. Differential sign: vagal reflexes (massage of the carotid sinus, Valsalva maneuver) slow the rhythm for a short time, helping to recognize the P waves.

Differential Diagnosis

• • Supraventricular paroxysmal tachycardia
  • Atrial flutter with regular conduction to the ventricles 2:1.

Treatment

• • Elimination of the identified risk factor: exclusion of smoking, drinking alcohol, strong tea, coffee, spicy food, sympathomimetic drugs (including drops

into the nose)

• • Treatment of the underlying disease
  • B-blockers in small doses orally (prescribed infrequently)
  • Sedative products
  • With concomitant heart failure – cardiac glycosides, pathogenetic therapy.

Reduction. ST – sinus tachycardia ICD. 149 Other cardiac arrhythmias