Sinus tachycardia

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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In the ECGquest archives, this ECG has been tagged with: - Hypotension Syncope 12-Lead Sinus arrhythmia Sinus tachycardia High grade AV block Ventriculophasic sinus arrhythmia Acute Inferior MI Acute Posterior MI Right ventricular MI ECG Interpretation CC-BY-NC-SA
ECG Blog #168 (STEMI – complex AV Block – Laddergram – Calipers)

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.

In the ECGquest archives, this ECG has been tagged with: - Abdominal pain Chest pain 12-Lead Coved ST elevation Peaked T waves Tachycardia Wide QRS Sinus tachycardia Hyperkalemia Dr Smith's ECG Blog CC BY-NC
Do you recognize this ECG yet?

This ECG is from a man in his 30s who presented with chest pain and RUQ abdominal pain, on a background of type 1 diabetes. His BSL was high.

This ECG shows sinus tachycardia with a wide QRS, R in aVR, coved ST elevation and peaked T waves. The cause was hyperkalemia.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Dyspnoea 12-Lead Anterior ST elevation Lateral ST elevation Sinus tachycardia LAFB RBBB Left main occlusion Dr Smith's ECG Blog CC BY-NC
How does acute left main occlusion present on the ECG? Case 2

This ECG is from a young woman who presented with sudden pulmonary oedema. This ECG was recorded just before she arrested.

This ECG shows sinus tachycardia, RBBB, LAFB and ST elevation in V2-6, I and aVL. The cause was a 100% left main occlusion.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest 12-Lead Sinus tachycardia Wide complex tachycardia Intraventricular conduction delay Dr Smith's ECG Blog CC BY-NC
ROSC: does the ECG to rule out OMI? And why does a heart just stop beating? And what rhythm is this?

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.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Hidden P waves Sinus tachycardia Dr Smith's ECG Blog CC BY-NC
Regular, steady, and fast at 170 (wide or narrow?), hypoxic, crackles in lungs, B-lines, unconscious

This ECG is from a man in his 60s who was found unconscious and hypoxic.

This ECG shows sinus tachycardia with P waves partially hidden in the T waves before them.

In the ECGquest archives, this ECG has been tagged with: - Dyspnoea Fever 12-Lead Regular Tachycardia Widespread ST elevation Sinus tachycardia Myocardial Bridging Dr Smith's ECG Blog CC BY-NC
Tachycardia, fever to 105, and ischemic ST Elevation — a Bridge too Far

This ECG is from a man in his 50s who presented with a high fever and dysonpea.

This ECG shows sinus tachycardia with widespread ST elevation. He was treated for sepsis but serial ECGs and troponins were abnormal. Angiogram showed a myocardial bridge in the mid LAD.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Anterior ST depression Inferior ST elevation Narrow QRS Normal Axis Normal P waves Reciprocal ST depression Regular Tachycardia Sinus tachycardia Multi-vessel disease Dr Smith's ECG Blog CC BY-NC
Arrhythmia? Ischemia? Both? Electricity, drugs, lytics, cath lab? You decide. Repeat 1 min later.

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.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead ST elevation in aVR Widespread ST depression Premature atrial complex Sinus tachycardia Aortic stenosis Dr Smith's ECG Blog CC BY-NC
An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR

This ECG is from a man in his 80s who presented with sudden onset chest pain and dyspnoea.

In the ECGquest archives, this ECG has been tagged with: - Loss of consciousness 12-Lead Inverted T waves Normal Axis Regular S1Q3T3 ST elevation in aVR Tachycardia Sinus tachycardia Acute right heart strain Pulmonary embolism Dr Smith's ECG Blog CC BY-NC
Comatose after opiate overdose, with tachycardia and hypotension
In the ECGquest archives, this ECG has been tagged with: - Chest pain 12-Lead Anterior ST elevation Hyperacute T waves Inferior ST elevation Lateral ST elevation Narrow QRS Normal Axis Regular Tachycardia Sinus tachycardia Acute Anterior MI Acute Inferior MI Acute Lateral MI ECG of the Week CC-BY-NC-SA
ECG of the Week – 20th August 2018 – Interpretation

This ECG is from a man in his 70s who presented with chest pain for the last 90 minutes, on a background of type 2 diabetes and hypertension.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea 12-Lead Serial 12-lead Fragmented QRS Normal P waves Tachycardia Wide QRS Sinus tachycardia Wide complex tachycardia LBBB Dr Smith's ECG Blog CC BY-NC
Sudden Chest pain and SOB with a Wide Complex Tachycardia: Repeat after unsynchronised cardioversion

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.

In the ECGquest archives, this ECG has been tagged with: - 12-Lead Serial 12-lead Regular Short QRS Tachycardia Sinus tachycardia Pericardial effusion Dr Smith's ECG Blog CC BY-NC
A Middle-Aged Man with Chest pain, Hypotension and Tachycardia: After cardioversion

This ECG is from a middle-aged man who presented with chest pain, tachycardia 130 bpm and BP 50/30. He was alert but cool and clammy. His background was unclear, but he mentioned chronic dyspnoea, 'cancer' and 'chest'. Fluids were started. This was his second ECG, on arrival at hospital.

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