Sinus tachycardia

Sinus rhythm with a resting heart rate of >100bpm in adults, or above the normal range in children.


  • In the vast majority of cases, a sinus tachycardia is a physiological response (via increased sympathetic innervation) e.g. during exercise, stress, infection, blood loss.
    • It is also seen with alcohol and caffeine consumption
  • The maximal heart rate for any individual can be calculated as 207-0.7×Age (years). More commonly, this is simplified to 220-Age.
  • Pathophysiological causes include
    • Hypoxia, hypercapnia, acidaemia
    • Sepsis, pyrexia
    • PE, heart failure
    • Hyperthyroidism
    • Drugs
      • Beta-agonists e.g. adrenaline, salbutamol, dobutamine
      • Sympathomimetics e.g. amphetamine, cocaine
      • Antimuscarinics e.g. antihistamines, TCAs, atropine
      • Caffeine, theophylline, marijuana
  • Patients can present with symtoms of the underlying cause.  Other symptoms may include palpitations, pre-syncope, anxiety etc
  • Management is almost always of the underlying cause; If the patient presents acutely (e.g. palpitations, SOB, syncope etc), manage as adult tachycardia (ABCDE) approach (see here)




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