Sinus tachycardia


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Sinus tachycardia

  1. 1. Sinus Tachycardia
  2. 2. Sinus Tachycardia• In an adult is characterized by a sinus rate of more than 100 beats/minute• Rate rarely exceeds 160 beats/minute except during strenuous exercise• Each impulse follows the normal pathway of conduction resulting in atrial and ventricular depolarization
  3. 3. Sinus Tachycardia• How it happens – Depends on the underlying cause • May be of no clinical significance – May be the body’s response to exercise – May be the body’s response to high emotional state • May also occur with hypovolemia, hemorrhage, or pain – When the stimulus for the tachycardia is removed, the arrhythmia spontaneously resolves
  4. 4. Sinus Tachycardia• Causes – Normal response to • Exercise, pain, stress, fever, or strong emotions – Certain cardiac conditions • Heart failure – Medications • Epinephrine and atropine – Substances • Caffeine, nicotine, and cocaine – Other conditions • Anemia, respiratory distress, pulmonary embolism, sepsis, and hyperthyroidism
  5. 5. Sinus Tachycardia• Hard on the heart – Not good for those with heart conditions already – Considered a poor prognostic sign if follows MI • Is associated with massive heart damage – Persistent tachycardia may signal impending heart failure or cardiogenic shock – Consequences • Bring on an episode of chest pain in patients with CAD
  6. 6. Sinus Tachycardia• What to look for – Look for a pulse rate of more than 100 beats/minute – Rhythm is regular
  7. 7. Symptomatic Tachycardia• Pulse rate of more than 100 beats/minute but with regular rhythm – Usually patient is asymptomatic
  8. 8. Symptomatic Tachycardia• If cardiac output falls and compensatory mechanisms fail – Will experience symptoms • Hypotension • Syncope • Blurred vision • Chest pain and palpitations • Nervousness or anxiety • Heart failure – JVD – crackles
  9. 9. Symptomatic Tachycardia• Steps to take – Prompt recognition is vital so treatment can be started – Provide the patient with a calm environment; help to reduce fear and anxiety which can fuel the arrhythmia – Tachycardia is commonly the first sign of pulmonary embolism
  10. 10. Symptomatic Tachycardia• When to call for help and what to do until help arrives – Look at the patient and ask how they are doing – Call for help if heart rate is too fast and/or symptomatic • Compare it their normal heart rate and rhythm – Stay with the patient – If the patient is not breathing and does not respond • Call code • ABCs/CPR
  11. 11. Sinus Tachycardia• What to look for – Look for a pulse rate of more than 100 beats/minute – Rhythm is regular
  12. 12. Sinus Tachycardia• Normal – P wave preceding each QRS complex – PR interval – QRS complex – T wave – QT interval
  13. 13. Sinus Tachycardia• P wave – Normal size and shape and precedes each QRS, but it may increase in amplitude – As the heart rate increases, the P wave may be superimposed on the preceding T wave and difficult to identify
  14. 14. Sinus Tachycardia• PR interval – Normal indicating that the impulse is following normal conduction pathways • 0.12-0.20 seconds
  15. 15. Sinus Tachycardia• QRS complex• Normal duration representing normal ventricular impulse conduction and recovery – Less than 0.12 seconds
  16. 16. Sinus Tachycardia• T wave – Upright in lead II, confirming that normal repolarization has taken place
  17. 17. Sinus Tachycardia• QT interval – Within normal limits • 0.36 to 0.44 seconds • QT normally shortens with tachycardia