Causes of sinus tachycardia and other types of tachycardia. Symptoms, ECG signs, treatment
Sinus tachycardia
Sinus tachycardia is the high rate of the sinoatrial node (SAN) with the cardiac rate of more than 100 beats per minute that relates to the types of supraventricular tachyarrhythmia.
A distinction is made between physiologic and pathologic sinus tachycardia (ST). A specific context of ST manifestation is central to determining the diagnosis and forecast for the future.
Physiologic ST arises in response to stress or physical load. So, ST is a normal response to psychoemotional overstrains, use of caffeinated drinks (energy drinks, adrenergic medications) or high level of physical activities. In these cases ST has temporary nature and, as a rule, does not cause subjective complaints. Cardiac rate normalization takes place just after termination of influence of the factors that have caused tachycardia.
Sinus tachycardia that persists at rest has clinical importance. Not infrequently, it is accompanied with senses of discomfort such as heartbeat, lack of air, languor, dizziness, buzzing in the head and in ears, sometimes vision impairment, frequent uriesthesia, pain in the heart area, etc. Such a tachycardia may be caused by either cardiac diseases or extracardiac factors.
- hypoxia;
- hypotonia;
- hypovolemia;
- hyperthermia;
- taking of adrenergic medications, intoxication with cardiac glycosides;
- thyrotoxicosis, pheocromocitoma;
- cardiomyopathy with left ventricular failure.
- hyperthyreosis;
- fever;
- acute vascular insufficiency;
- respiratory disturbance;
- anemia;
- some types of neurocirculatory dystonia accompanied with the activation of the sympathoadrenal system;
- use of certain types of medications such as sympathomimetics, euphylline, caffeine, peripheral vasodilator, calcium channel-blocking agents.
- chronic cardiac insufficiency;
- myocardial infarction;
- severe anginal attack of patients with coronary heart disease;
- acute myocarditis;
- cardiomyopathies (hypertrophic cardiomyopathy, dilated cardiomyopathy);
- coronary sclerosis;
- cardiosclerosis;
- mitral valve prolapse, etc.
Diagnostics of ST is performed with ECG which shows the following indicators in such a case:
- increase in heart rate, more than 100 beats per minute;
- correct sinus rhythm is preserved;
- positive Р wave in the leads I, II, аVF, V4-V6.
In case of apparent ST we can observe as follows:
- reduction of Р-Q (R) interval (but not less than 0.12 sec) and continuance of Q-Т interval;
- increase of Р amplitude in the leads I, II, аVF;
- increase or decrease of T-deflection amplitude;
- upsloping ST segment depression (not more than 1 mm below the isoline).
A patient should also undergo the echocardiography to reveal the changes in the heart structure and the dimensions of the cavities, do blood and urine tests, tests to determine thyroid and adrenal capsule hormone level, additional examinations if it is necessary to specify a comorbidity.
A patient should first change his/her lifestyle to prevent the possibility of sinus tachycardia attacks, which means
- good night sleep (not less than 8 hours),
- rejection of smoking and alcohol,
- five meals a day without the products containing caffeine and other excitors, fatty, spicy and oversalted food, increase of the amount of vegetable, fruit and berries (not less than 60 %), but also not outeat,
- avoid fatigue and psychoemotional supertensions, especially stresses,
- perform dosed exercise daily (the best options are swimming, terrenkur, jogging, etc.),
- outdoor hiking for not less than 45–50 minutes.
It is useless to treat the sinus tachycardia. At first the causes that trigger rapid heartbeat should be eliminated. If it is a disease, then the main (primary) disease should be treated. Besides, ST is often a precursor of paroxysmal tachycardia or auricular fibrillation that may become an additional threat in the future.
The patients that have doubts about the occurrence of heart disorders should visit a cardiologist, the doctor who works in the area of diagnostics and treatment of cardiovascular pathologies studying acknowledged approaches to diagnostics and treatment of supraventricular arrhythmias, among other diseases. The final decision on the help for a certain patient should be taken by a doctor and a patient taking into account particular characteristics of the case.
Article writer - Yuri Matyash
Publication date: 10.06.2020
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