II. Definitions
- Inappropriate Sinus Tachycardia
- Resting Heart Rate is consistently above physiologic range without physiologic or metabolic cause
- Exaggerated Heart Rate response to minimal exertion or body position change
III. Precautions
- Exclude the large number of Sinus Tachycardia causes before diagnosing Inappropriate Sinus Tachycardia
- Missed serious causes of Sinus Tachycardia may result in significant morbidity and mortality
IV. Risk Factors
- Teens or young adults
- Psychosomatic disorders
V. Symptoms
-
General
- Many of these cardiopulmonary symptoms are also see with serious causes (e.g. PE, ACS, Sepsis)
- Chest Pain
- Dyspnea
- Presyncope
- Anxiety
- Palpitations
VI. Signs
- Adults with Heart Rate consistently >100 beats per minute
VII. Differential Diagnosis
VIII. Management
- Exclude all other causes of Sinus Tachycardia
- Consider Autonomic Dysfunction (esp. POTS Syndrome)
- Activities that increase vagal tone (e.g. Yoga)
- Avoid stimulants and other triggers
- Consider symptomatic management with AV Nodal Blockers
- Beta Blockers (e.g. Propranolol, Metoprolol) for PVCs or PACs
- Non-Dihydropyridine Calcium Channel Blocker (e.g. Diltiazem, Verapamil) for PVCs