Sinus tachycardia has the same features of a normal sinus rhythm except that the rate is fast (>100 bpm). The rhythm is regular, with a normal P wave and PR interval. The maximum rate is around 220-age (e.g. 200 bpm for a 20 year old, or 140 bpm for an 80 year old).
There are many causes of sinus tachycardia, including exercise, fear, pain, drugs (including caffeine), fever, hypotension, hyperthyroidisim, myocarditis and cardiomyopathy.
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This ECG is from a middle-aged woman who presented with syncope and hypotension.
This ECG shows sinus tachycardia with inferior ST elevation and reciprocal ST depression in aVL. Also ST elevation in V1 and ST depression in V2-4. The most likely cause was acute inferoposterior MI due to proximal RCA occlusion.
This ECG is from a man in his 60s who complained of feeling weak and then collapsed. He was given CPR and a pulse returned after several minutes.
This ECG shows wide complex tachycardia with P waves visible best in V1. IVCD. No marked ischemic ST changes. Angiogram found a 90% left main stenosis, 100% LAD occlusion and moderate to severe proximal RCA disease.
This ECG is from a man in his 60s who presented with intermittent shortness of breath and chest pressure over the past few days. This was his repeat ECG after the rhythm changed.
This ECG shows a sinus tachycardia with ST elevation in inferior leads and ST depression in anterior leads and aVL. He underwent angiography and had stents inserted to the left circumflex and right coronary arteries.
This ECG is from a man in his 60s who presented with sudden onset severe chest pain and dyspnoea. He had no medical history or medications. On arrival he was in extremis with altered mentation, cyanosis and diaphoresis . There was no palpable radial pulse. Pulse oximetry read HR 170 and saturation 53%. This was the repeat ECG after unsynchronised cardioversion.