Sinus Tachycardia

Question 1

Define sinus tachycardia in adults.

Answer 1

A heart rate of > 100 bpm where eache narrow-complex QRS complex is preceded by a P wave.

Question 2

What are the clinical features of sinus tachycardia?

Answer 2

1. HR > 100
2. Dizziness, syncope
3. Chest pain, palpitations
4. Dyspnea

Question 3

What are CNS-related causes of sinus tachycardia?

Answer 3

Light anesthesia
Pain
Anxiety
Stress

Question 4

What are cardiovascular conditions that should be considered in the differential diagnosis of sinus tachycardia?

Answer 4

Reflex tachycardia
SVT or VT
AFib/AFlutter
Restrictive cardiomyopathy
Pulmonary embolism
Sick Sinus Syndrome

Question 5

What are pulmonary conditions that should be considered in the differential diagnosis of sinus tachycardia?

Answer 5

hypoxemia
hypercarbia
tension pneumothorax

Question 6

What are metabolic/endocrine conditions that should be considered in the differential diagnosis of sinus tachycardia?

Answer 6

Malignant hyperthermia
Fever, sepsis
Hypoglycemia
Carbon Monoxide Poisoning
Thyrotoxicosis
Pheochromocytoma
Carcinoid tumor

Question 7

What drugs commonly cause sinus tachycardia?

Answer 7

Anticholinergic
Other vagolytics: pancuronium, desflurane, meperidine
Sympathomimetics
Histamine-releasing drugs

Question 8

What is the treatment of sinus tachycardia?

Answer 8

1. Ensure adequate oxygentation and ventilation
2. Check EKG and r/o SVT or wide-complex tachycardia
3. Check depth of anesthesia (check delivery systems)
4. Check core temperature, EtCO2
5. Assess volume status
6. Review drugs delivered (insufficient, drug error?)
7. Review chart and consider differential diagnosis.