Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ KEY FEATURES +++ ESSENTIALS OF DIAGNOSIS ++ Heart rate 100–160 bpm Each QRS is preceded by a P wave identical to the P wave of normal sinus rhythm Physiologic response to exercise or adrenergic response to disease +++ GENERAL CONSIDERATIONS ++ Common causes: – Blood loss – Volume depletion – Hyperthyroidism – Fever – Sepsis – Pulmonary embolism – Hypotension Heart rate achieved is proportional to the intensity of the stimulus Rate changes result from a shift of pacemaker activity within sinus node Carotid sinus massage or Valsalva maneuver may temporarily slow the heart rate, and the rate returns to baseline upon cessation of the maneuver Common in infancy and early childhood Thyroid medication excess, alcohol, nicotine, and caffeine may cause sinus tachycardia Sinus tachycardia after heart transplantation carries adverse prognosis Persistent sinus tachycardia may be a manifestation of heart failure May be appropriate response to stimuli, or inappropriate without any provocation +++ CLINICAL PRESENTATION +++ SYMPTOMS AND SIGNS ++ Palpitations Depends on precipitating cause +++ PHYSICAL EXAM FINDINGS ++ Other than tachycardia, findings depend on underlying precipitating cause +++ DIFFERENTIAL DIAGNOSIS ++ Sinus node reentry Atrial tachycardia +++ DIAGNOSTIC EVALUATION +++ LABORATORY TESTS ++ Thyroid-stimulating hormone CBC, basic metabolic panel Depending on clinical suspicion +++ ELECTROCARDIOGRAPHY ++ ECG +++ IMAGING STUDIES ++ If heart failure is suspected, then echocardiogram to evaluate left ventricular function +++ DIAGNOSTIC PROCEDURES ++ None required +++ TREATMENT +++ CARDIOLOGY REFERRAL ++ Generally not required +++ HOSPITALIZATION CRITERIA ++ Depends on underlying precipitating cause +++ MEDICATIONS ++ Treat underlying cause +++ THERAPEUTIC PROCEDURES ++ None required +++ SURGERY ++ None required +++ MONITORING ++ Depends on precipitating cause +++ DIET AND ACTIVITY ++ General healthy lifestyle +++ ONGOING MANAGEMENT +++ HOSPITAL DISCHARGE CRITERIA ++ Depends on underlying clinical illness +++ FOLLOW-UP ++ Depends on precipitating cause +++ COMPLICATIONS ++ Usually none If tachycardia is inappropriate and persistent, it may lead to cardiomyopathy +++ PROGNOSIS ++ Depends on precipitating cause Tachycardia resolves with the cure of the inciting condition +++ RESOURCES +++ PRACTICE GUIDELINES ++ Management: – Identify a secondary cause and treat – Beta ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.