Sinus tachycardia

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