Evaluation of a Patient with Sinus Tachycardia

Sinus tachycardia is associated with a heart rate > 100 beats per minute.

Types:

(1) normal (persistent)

(2) inappropriate (persistent)

(3) postural orthostatic tachycardia syndrome (POTS; paroxysmal)

(4) sinus node reentry tachycardia (SNRT; paroxysmal)

Normal sinus tachycardia is persistent and associated with an identifiable underlying cause (physiologic, pathologic, pharmacologic) and the increase in heart rate is appropriate.

Inappropriate sinus tachycardia shows:

(1) a persistent increase in heart rate

(2) no cause is identified or the level is not appropriate for the patient's condition.

(3) the heart rate often normalizes at night

Postural orthostatic tachycardia syndrome (POTS):

(1) tachycardia is triggered by orthostatic trigger and resolves if recumbent

(2) there is no significant hypotension while erect

(3) no underlying cause identified

(4) no sign of autonomic neuropathy

Sinus node reentry tachycardia:

(1) sudden and paroxysmal onset

(2) usually not sustained

(3) triggered by an atrial premature beat

(4) the heart rate may range from 80 to 150 beats per minute