The Trouble with Sinus Tachycardia

  Sometimes recognizing sinus tachycardia can give us fits. What? Sinus tachycardia? One of the most basic rhythms? The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that this issue is easy to navigate. It can get very difficult, and very dicey. The consequences of misinterpreting the rhythm and missing sinus tach can have very deleterious effects for our patients. We are all good at recognizing sinus tachycardia at rates between 100-150, but when rates exceed 150 it seems to become problematic. Is it difficult to recognize this? No. How about this one? More difficult.   When sinus tachycardia occurs at high rates, our ability to correctly differentiate it from other types of SVT apparently decreases. P waves start to blend into the T waves. Instead of talking about discreet stand alone P waves, we talk about "notches" and "bumps". It is all too easy to look at a rate >150 and simply call it "SVT".   We know what sinus tach is: a sinus rhythm at rates faster than 100 (in adults), which is a normal physiological response to compensate for the increased needs of the body. I won’t spend time listing all of the possible causes, ranging from running around the block to septic shock. AVNRT, a type of SVT that is responsive to Adenosine, is a re-entrant ...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG ACLS David Baumrind ems12lead.com narrow complex tachyardias sinus tachycardia SVT treating SVT with adenosine Source Type: research