1. Sinus Tachycardia

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. 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. 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. 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. Sinus Tachycardia
• What to look for
– Look for a pulse rate of more than 100
beats/minute
– Rhythm is regular

7. Symptomatic Tachycardia
• Pulse rate of more than 100 beats/minute but
with regular rhythm
– Usually patient is asymptomatic

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. 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. 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. Sinus Tachycardia
• What to look for
– Look for a pulse rate of more than 100
beats/minute
– Rhythm is regular

12. Sinus Tachycardia
• Normal
– P wave preceding each QRS complex
– PR interval
– QRS complex
– T wave
– QT interval

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. Sinus Tachycardia
• PR interval
– Normal indicating that the impulse is following
normal conduction pathways
• 0.12-0.20 seconds

15. Sinus Tachycardia
• QRS complex
• Normal duration representing normal
ventricular impulse conduction and recovery
– Less than 0.12 seconds

16. Sinus Tachycardia
• T wave
– Upright in lead II, confirming that normal
repolarization has taken place

17. Sinus Tachycardia
• QT interval
– Within normal limits
• 0.36 to 0.44 seconds
• QT normally shortens with tachycardia