Inappropriate sinus tachycardia

Definition

• 24h average greater than 90
• More common in young women

Differential Diagnosis

• Appropriate sinus tachycardia
  • Pain and anxiety
  • Fever, infection, and sepsis
  • Hypovolemia
  • Pulmonary embolism
  • Anemia
  • Hyperthyroidism
  • Pheochromocytoma
• Focal atrial tachycardia (i.e. not sinus node)
• Sinus node reentrant tachycardia
• Postural orthostatic tachycardia syndrome (POTS)

Management

• Only if symptomatic
• Ivabradine as first line
• Beta blockers or calcium channel blockers as second line
• Ablation if really bad