EKG

Inappropriate Sinus Tachycardia

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Inappropriate Sinus Tachycardia

  • See Also
  1. Sinus Tachycardia
  • Definitions
  1. Inappropriate Sinus Tachycardia
    1. Resting Heart Rate is consistently above physiologic range without physiologic or metabolic cause
    2. Exaggerated Heart Rate response to minimal exertion or body position change
  • Precautions
  1. Exclude the large number of Sinus Tachycardia causes before diagnosing Inappropriate Sinus Tachycardia
  2. Missed serious causes of Sinus Tachycardia may result in significant morbidity and mortality
  • Risk Factors
  1. Teens or young adults
  2. Psychosomatic disorders
  • Symptoms
  1. General
    1. Many of these cardiopulmonary symptoms are also see with serious causes (e.g. PE, ACS, Sepsis)
  2. Chest Pain
  3. Dyspnea
  4. Presyncope
  5. Anxiety
  6. Palpitations
  • Signs
  1. Adults with Heart Rate consistently >100 beats per minute
  • Differential Diagnosis
  1. See Sinus Tachycardia
  2. Autonomic Dysfunction or Dysautonomia (e.g. Postural Orthostatic Tachycardia Syndrome)
  • Management
  1. Exclude all other causes of Sinus Tachycardia
  2. Consider Autonomic Dysfunction (esp. POTS Syndrome)
  3. Activities that increase vagal tone (e.g. Yoga)
  4. Avoid stimulants and other triggers
  5. Consider symptomatic management with AV Nodal Blockers
    1. Beta Blockers (e.g. Propranolol, Metoprolol) for PVCs or PACs
    2. Non-Dihydropyridine Calcium Channel Blocker (e.g. Diltiazem, Verapamil) for PVCs
  • References
  1. Gauer (2024) Am Fam Physician 110(3): 259-69 [PubMed]