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.
See also: Sinus Rhythms
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- Houghton, AR and Gray, D (2014) - Making Sense of the ECG: A Hands-on Guide, 4th edn, Taylor and Francis
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.
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 ECG was recorded the next day, after the arrhythmia recurred and was treated with ibutilide.
This ECG is from a young man who was found at the bottom of his basement stairs. He complained of right hip or leg pain but seemed confused about what had happened. He had a history of IV heroin abuse. Shortly after he had a wide complex PEA arrest and had a ROSC after 20 min of resuscitation with epinephrine, glucose, calcium and bicarb. This was his baseline ECG from a previous presentation.