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.


    • 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



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