Is this a Sinus Tachycardia?? KK, a 67 year old female is seen in the Emergency

Question

Is this a Sinus Tachycardia??

KK, a 67 year old female is seen in the Emergency Room following a morning of “feeling off.” She has never felt like this before. She reports that she has had no recent illnesses and has not traveled recently. KK is negative for: fever, chills, diarrhea, abdominal pain, nausea, vomiting, or headache. She began feeling dizzy during mid-morning. She reports feeling like her heart was pounding at the same time. She was delivered to the hospital by noon where she was seen almost immediately. She has no chest pain but she feels “like a heavy weight is on top of her chest.” There is no history of heart disease. Patient is alert and oriented. Her vital signs and ECG (on page 3; note the arrow) follow.

Vital signs:

BP: 102/50

HR: 140

RR: 16

Temp: 37.2 degrees C

5. Given the following results of an ECG (below), and the possible results of medications/manipulations in #4, what is your diagnosis of this patient? Note the arrow

Explanation / Answer

Yes, it is sinus Tachycardia. Tachycardia literally means an excessively fast heart rate (say more than 100 beats per minute) and Sinus indicates that the rate is driven by the heart's normal pacemaker and is therefore still responding to natural regulatory reflexes.

Sinus tachycardia is indicated on an ECG with a normal upright P wave in lead II preceding every QRS complex with an atrial rate of greater than 100 per minute. Usually the ventricular rate is also greater than 100 since in most cases the P wave conducts through the AV node to the ventricles to produce a QRS complex in a 1:1 fashion.

Symptoms: When your heart is beating too fast, it may not pump blood effectively to the rest of your body. This can deprive your organs and tissues of oxygen and can cause the following tachycardia-related signs and symptoms:

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