sinus tachycardia

Causes

  • sepsis
    • fever
    • usually persistent
  • volume
    • Anemia
    • Dehydration
    • usually persistent
  • stress
    • Pain
    • Anxiety
    • ACS
    • HF
  • others
    • Withdrawal
    • Intoxication
    • TSH

Inappropriate sinus tachycardia

  • IST
  • pt: women in 30s-40s
  • elevated resting heart rate
  • exaggerated increase with light activity
  • decreased rate with sleep
  • treatment:
    • removal of aggrevating factors, exercise
    • BB, CCB, ivabradine

POTS

  • postural orthostatic tachycardia syndrome, POTS syndrome
  • dysautonomia
  • tachycardia with standing
  • diagnostic criteria
    • HR increase 30 or more OR
    • increase to >120
    • within 10 minutes of standing
  • dx
    • confirm with tilt table test
  • treatment
    • behavioral modification
    • compression stocking
    • exercise training
    • increase fluid intake
    • BB, fludrocortisone, SSRI, midrodrine, pyridostigmine