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Concept
Sinus tachycardia
Résumé
Sinus tachycardia is a sinus rhythm with an increased rate of electrical discharge from the sinoatrial node, resulting in a tachycardia, a heart rate that is higher than the upper limit of normal (90-100 beats per minute for adult humans).
The normal resting heart rate is 60–90 bpm in an average adult. Normal heart rates vary with age and level of fitness, from infants having faster heart rates (110-150 bpm) and the elderly having slower heart rates. Sinus tachycardia is a normal response to physical exercise, when the heart rate increases to meet the body's higher demand for energy and oxygen, but sinus tachycardia can also indicate a health problem. Thus, sinus tachycardia is a medical finding that can be either physiological or pathological.
Tachycardia is often asymptomatic. It is often a resulting symptom of a primary disease state and can be an indication of the severity of a disease. If the heart rate is too high, cardiac output may fall due to the markedly reduced ventricular filling time. Rapid rates, though they may be compensating for ischemia elsewhere, increase myocardial oxygen demand and reduce coronary blood flow, thus precipitating an ischemic heart or valvular disease. Sinus tachycardia accompanying a myocardial infarction may be indicative of cardiogenic shock.
Sinus tachycardia is usually a response to physiological stress, such as exercise, or an increased sympathetic tone with increased catecholamine release, such as stress, fright, flight, and anger. Other causes include:
Pain
Fever
Anxiety
Dehydration
Malignant hyperthermia
Hypovolemia with hypotension and shock
Anemia
Hyperthyroidism
Mercury poisoning
Kawasaki disease
Pheochromocytoma
Sepsis
Pulmonary embolism
Acute coronary ischemia and myocardial infarction
Chronic obstructive pulmonary disease
Hypoxia
Intake of stimulants such as caffeine, theophylline, nicotine, cocaine, or amphetamines
Hyperdynamic circulation
Electric shock
Drug withdrawal
Porphyria
Acute inflammatory demyelinating polyradiculoneuropathy
Postural orthostatic tachycardia syndrome
Mitral Valve Prolapse
Metabolic Myopathies
Sinus tachycardia is usually apparent on an ECG, but if the heart rate is above 140 bpm the P wave may be difficult to distinguish from the previous T wave and one may confuse it with a paroxysmal supraventricular tachycardia or atrial flutter with a 2:1 block.
Source officielle
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