ABSTRACT
Inappropriate Sinus Tachycardia is a chronic medical condition with a wide variety of clinical presentations making it, sometimes, very insidious at the time of the diagnosis. Several therapeutic options including, pharmacotherapy, cardiac rehabilitation and modification or ablation of the sinus node have been proposed for the management of Inappropriate Sinus Tachycardia. But due to the complexity and not well understood pathophysiology, it can be difficult to manage despite the numerous treatment options currently available. The purpose of this review is to analyze the treatment for Inappropriate Sinus Tachycardia focusing on the role of newer therapy and the potential benefits in the management of this cardiac rhythm
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The clinical presentation of patients with IST can vary due to the diversity of its multiple symptoms including: intermittent palpitations, dyspnea, dizziness, lightheadedness, pre-syncope, syncope, chest pain, myalgia, and fatigue. [12] Associated psychological and emotional problems can also be seen, but no relationship with IST has been identified. [8]
Using a criteria of a resting heart rate >100 bpm and an average heart rate of >90 bpm on 24-hour Holter monitoring, Still et al., estimated the prevalence of IST in a middle-aged population of men and women. The IST prevalence was 1.2% (7 of 604 patients) [2], including both symptomatic and asymptomatic patients. IST has also been reported in older population. [5] Although, IST is believed to be a chronic condition, long-term complications are few. IST has been associated with tachycardia-induced cardiomyopathy in isolated cases [6][7] and no mortality has been yet reported.
IST is a medical entity that should be diagnosed by exclusion, medical history and physical examination and should be assessed thoroughly, aiming to the potential causes of sinus tachycardia, thus, thyroid disease, medications, hypovolemia, panic attacks, anxiety and substance abuse should be ruled out. A 12-lead EKG is useful for recording tachycardia and defining sinus rhythm, which helps differentiate IST from
The abnormally fast heartbeat caused by SVT, lasts in episodes lasting for several hours. During an episode
Supraventricular tachycardia or SVT is a heart condition where the sufferer’s heart beats very fast for reasons such as exercise, high fever, caffeine or stress. For the majority of people who have supraventricular tachycardia, the heart still works as normal where it pumps blood across the body. During an episode of supraventricular tachycardia, the heart's electrical system doesn't work properly, causing the heart to beat very fast. The heart will beat at least 100 beats per minute and may reach up to 300 beats per minute. After medical treatment or treatment of its own, the heart will usually return to a normal rate of around 60 to 100 beats per minute. Supraventricular Tachycardia may start suddenly and then end suddenly, and you may not
Resting heart contractions were recorded for thirty seconds until the heart rate was less than 60 beats per minute. A stimulator electrode to be used was set to the following states: Amplitude of 4.00 Volts, a stimulus delay of 50ms, stimulus duration of 10ms, a frequency of 1.0Hz, and a pulse number of 30. The electrode was then placed in direct contact with the heart for 30 seconds at which time the data was observed and recorded.
To determine if the patient’s chest pain is related to cardiac ischemia, you would look for ST-segment depression and/or T wave inversion. If the ST-segment depression is at least 1mm (one small box) below the isoelectric line, it is significant and occurs in response to inadequate supply of blood and oxygen, which leads to an electrical disturbance. Once this is treated, adequate blood flow is restored, the ECG changes will resolve, and the ECG will return back to patient’s baseline.
Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of the heart. Problems will occur with the heart as tachycardia persists over time. The heart is maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea, COPD, electrolyte imbalances, and many more.
Parker included collecting cues in 12-lead ECG, blood pressure, potassium level, sodium level, the warmth of hands and feet and pain score (Corrales-Medina et al., 2012). Also, the process involved identifying the risk factors associated with the patient's condition. From the immediate assessment, it included weight, smoking history, history of depression and family history of cardiac conditions (Corrales-Medina et al., 2012). One evening, Mr. Parker slumped on the bed; I monitored the continuous cardiac monitor to determine his heart rhythm. Based on current information, the T wave on the ECG indicated that the ventricles are repolarising (Levett-Jones et al., 2010).
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P
In the evaluation of patients with chest pain, the preliminary ECG is a more clear-cut tool for early risk stratification with more recent recommendations indicating that ECG should be performed as early as possible, within 10 minutes of ED admittance. Early indicators associated with MI or ischemic complication such as ST segment elevation or depression allows rapid treatment aligning with the indicated complication. While the ECG may reveal significant indicators in certain situations, in other circumstances findings may be limited due to low diagnostic sensitivity
Cardiovascular. Client denies chest pain, palpitations, murmurs, any arrhythmias, hypertension, awakening at night with shortness of breath, or dizzy spells. Client has not had an electrocardiogram.
Supraventricular tachycardia is increase in heart rate over 150 bpm due to do the over firing or redirected firing of the SA Node conduction above the ventricles. With supraventricular tachycardia the patient can have an abrupt onset and termination of rhythm, flattened or retrograde conduction P waves and narrow QRS waves specifically less than 0.08 second (Kyle, 2012).
An interesting case I attended to involved an elderly man in his 80s who is a non-smoker and non-alcoholic. He looked grayish, pale and sweaty, which is the typical appearance of a cardiac patient. He presented with chest pain that he gave a pain score of 8/10, and which worsened upon inspiration. He also presented with vomiting and shortness of breath. Electrocardiogram (ECG) indicated a ST Elevation Myocardial Infarction (STEMI). Paramedic believes it was an anterior infarct with elevation in V2, V3, V4 leads and reciprocal depression in Leads II, III and aVF. The patient had several risk factors for heart disease such as high blood pressure, being overweight and living a sedentary lifestyle. He has had chest pain previously, but it was
They also must withdraw blood to check for any condition. Inappropriate sinus tachycardia is a condition that is presented with similar symptoms of Postural Orthostatic Tachycardia Syndrome (Busmer 19). It may be difficult for medical professionals to differentiate these two conditions. Some techniques have been prone to minimize the risk of falls which consist of avoiding standing for long periods of times and if possible to keep moving. ”Postural Orthostatic Tachycardia Syndrome is a life changing condition, often affecting healthy, young, fit and active people. It affects every aspect of their lives and consequently their physiological wellbeing” (Busmer 20). Some things that could happen because of Postural Orthostatic Tachycardia Syndrome are deconditioning because of poor tolerance of exercise. People who are diagnosed with Postural Orthostatic Tachycardia Syndrome need to go through a support of any kind such as practically and emotional. Some things are made to raise awareness through healthcare professionals. Research is also needed to understand Postural Orthostatic Tachycardia Syndrome and how to approach and manage or cure this
The patient, Meriem Haile has been complaining of chest pains along with many other symptoms. She had cardiac catheterization, coil occlusion of PDA, done at the age of 16, for congenital defect. Now she has been diagnosed with SVT (supraventricular tachycardia), occurring 8% of the time. She complains of headaches that come after any physical activity, such as going up stairs. She used to be able to run cross country, but now stopped doing any exercise due to the recurring headaches. She also complains of experiencing blackout when standing up from a sitting position.
ECG : ventricular rate 54 beats/min, HR varying from 39 to 60 during a 45 minute period of monitoring, infrequent PVCs, ST elevation in leads II, III and avF indicating inferior injury or ischemia secondary to acute MI.
In addition, scientists have found that genetics also plays a role in cardiac arrhythmias and that in some cases patients have commented that they had no symptoms before they succumbed to some form of episode of cardiac distress, like a sudden heart attack. This has proven to be standard for many different forms of arrhythmias, whether it’s due to genetics or not. One such case is the long QT syndrome (LQTS) which is estimated to affect one in every 5000 people and is recognized as a family disorder, frequent in children during their childhood years (Wilde, and Bezzina 1352–1358.) Patients with this disorder can have symptoms of a fluttering heartbeat, shortness of breath, and chest pain, while other patients might not experience any symptoms at all (Wilde, and Bezzina 1352–1358.) Another known disorder is cardiac conduction disease, which is mostly due to some form of cardiac injury (Wilde, and Bezzina 1352–1358.) Symptoms for this