Sinus tachycardia: causes, symptoms and signs, how and when to treat. Features of sinus tachycardia and methods of its treatment Diagnosis of sinus tachycardia

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What it is? Sinus tachycardia of the heart is a type of arrhythmia (sinus), characterized by the development of disturbances in heart rate exceeding 90 beats/min. It develops as a consequence of increased activity of the sinotrial (sinus) node “Kisa-Flyak”.

Sinus tachycardia (ST for short) is the most common type of frequent heart rate disruptions, manifested by their significant increase, while maintaining normal consistency and rhythm. For humans, sinus tachycardia can be either a normal variant or a consequence of the development of various diseases in the body. Occurs in patients of any age, regardless of gender.

For example, the fight-or-flight reflex is triggered by the release of adrenaline during fear, accompanied by rapid heart contractions. When the danger has passed, the heart rate returns to the normal limit (90 beats/min). This type of ST is called physiological.

The manifestation of sinus tachycardia during pregnancy is also considered a normal physiological phenomenon, caused by changes in the entire internal system of the woman carrying a child. Attacks can be isolated and are easily tolerated by women in the early stages or in the last trimester of pregnancy.

Pathological The phenomenon is considered to be a rapid heartbeat that does not depend on external causes, but is a consequence of a violation of myocardial innervation, or dysfunction of the Kisa-Flyak node. Sinus tachycardia of the heart develops even in a calm state, begins smoothly, gradually increasing to 220 beats/min. At the same time, the heart rhythm does not falter and remains normal.

Depending on the increase in heart rate, sinus cardiac tachycardia may manifest itself:

Moderate in nature - the increase in heart rate does not exceed 20% of normal values (certain fluctuations depend on the age and activity of the patient).
Average - not exceeding standard figures more than 40%.
Expressed in nature, which is the most dangerous condition in which the heart rate reaches more than 60% or even exceeds these indicators.

Why is sinus tachycardia dangerous?

In itself, the danger of cardiac sinus tachycardia is not considered - it is simply accelerated work of the myocardium. The danger is caused by the development of pathological TS, which provokes “idle” wear and tear of the heart due to inadequate filling of the cardiac ventricles with blood and inadequate release of blood into the vessels.

At the same time, the heart rate accelerates, blood pressure drops and there is insufficient oxygen supply to the organs. With a significant increase in heart rate, the risk of developing blood clots in the cardiac cavities increases.

Prolonged hypoxia provokes:

development of cardiac ischemia;
cardiac and cerebrovascular insufficiency;
inflammatory processes in the myocardium (myocarditis).

In the future, the patient will experience ventricular tachyarrhythmia (uncoordinated contraction of the heart ventricles) and complete inability of the heart to pump blood. These are the main dangers of sinus tachycardia.

Sinus tachycardia in children - symptoms and features

Indicators of the development of sinusoidal tachycardia in adult patients are more understandable because they imply an increase in heart rate - 100, 120 beats/min. But sinus “sinusoidal” tachycardia in a child and what it is is a loose concept. This is due to heart rate rates that are much higher than adults and differ in the age group of children. The younger the child, the more acceptable is his increased heart rate.

In children, signs of sinus tachycardia can be observed when they express any emotions, when they are happy or irritated, when they are gnawing at resentment, pain and anger. This is how their psyche works and the child completely surrenders to his emotions.

If the situation does not stabilize within 10 minutes after eliminating the provoking factor, then you should sound the alarm. Otherwise, the heart soon returns to its normal rhythm and no therapeutic interventions are required.

Up to 10 years of age, pathological disruptions in cardiac function can be observed as a result of an increase in body temperature (provoked by any disease) if the child is in a hot confined space or at a high elevation for a long time.

If high readings (up to 140 beats/min) do not cause any cardiac discomfort, this is a physiological phenomenon and there is no need for therapeutic intervention.

Sinus tachycardia in infants

Almost half of newborn babies are diagnosed with sinus tachycardia. And for the majority, the pathology resolves on its own, without manifesting itself in the future as any cardiac pathologies.

However, we cannot exclude many factors due to different genesis that contribute to the development of TS at this age. These include:

hereditary form of heart failure;
signs of myocarditis and acidosis;
the child has hypoglycemia or anemia;
pathological processes in the central nervous system.

With such a history, the detection of TS may be an alarming sign, indicating probable pathological processes in the nervous system or circulatory system.

But the reverse development is also possible, when, as a result of prolonged sinusoidal tachycardia, an acquired form of cardiac dysfunction occurs in newborns.

TS in children of preschool and primary school age

The development of sinusoidal tachycardia in children of preschool and school age can be caused by natural and psychological factors - with a sharp increase in air temperature, pressure, difficult adaptability in a team, or fear of the teacher.

Confidential conversations with the child, or taking herbal sedatives can improve the situation.

TS at puberty

A provocative factor in the development of TS in adolescents is the unstable hormonal background that accompanies this age period. The situation can be provoked by the failure of the myocardium, which does not keep up with the muscular and skeletal growth of the child.

Heart rate acceleration occurs to replenish the body’s “expenses” in response to long-term processes of excessive childhood activity. It usually manifests itself in children of puberty with headaches and surges in blood pressure.

Accelerated maturation causes hormonal changes, violent emotions, nervousness and worries, leading to an increased release of adrenaline into the blood, which affects the excitability and conductivity functions of the Kisa-Flyaka node. Teenagers tend to feel a slight pain syndrome in the heart area, experience heaviness in the chest and fainting, but there is no danger to the normal functional activity of the heart.

If from the moment of birth the normal heart rate for children is considered to be 160 beats/min, then each subsequent year reduces this norm by 10%. Therefore, before reaching puberty, the heart rate will be no more than 130 beats/min.

Signs and symptoms of sinus tachycardia

With physiological sinus tachycardia, symptoms rarely give a clear picture. The pathology is manifested by an accelerated heartbeat and slight pain in the heart, and an unpleasant heaviness in the chest area. With pathological sinusoidal tachycardia, the signs are more pronounced and appear:

constant increased heartbeat - loud, rhythmic, fast beats;
a feeling of lack of air, causing shortness of breath;
heart attacks accompanied by weakness and dizziness, flickering in the eyes and fainting;
weakness in the limbs;
short-term sleep with frequent awakenings, insomnia and a feeling of irritability;
decreased appetite and bad mood.

A long course of the disease leads to a decrease in blood pressure and the development of persistent hypotension, manifested by coldness of the extremities and the development of oliguria.

The severity and nature of symptoms depends on the background pathology that provokes the arrhythmia and on the individual properties of the central nervous system. For example, angina attacks appear as a consequence of coronary atherosclerosis, and irritability and insomnia (insomnia) are a consequence of arrhythmia of a neurological nature.

The symptoms of sinus tachycardia are not always unambiguous - in each patient it manifests itself in a separate clinical set. But except for newborn children, they manifest themselves in the same way in all patients, and only because babies are not able to talk about their painful sensations.

Treatment of sinus tachycardia, drugs

Among the treatment methods for sinus tachycardia, there are two options: complex drug therapy and surgical intervention. The treatment plan is based on the identification and drug treatment of provoking diseases against which the disease develops.

Treatment drugs consist of two basic groups:

Sedatives based on herbal components, valerian root - the drug "Novopassit" and synthetic drugs such as "Phenobarbital" or "Diazepam". These drugs reduce the frequency and duration of attacks and normalize nervous functions.
Antiarrhythmic drugs. This is a very broad group of drugs. It is selected individually, taking into account contraindications, allergic reactions and many other individual characteristics. The most commonly prescribed are Flecainide, Verapamil, Adenosine or Propranorol.

Sometimes, the tactics of drug treatment of sinus tachycardia do not produce a positive effect. Surgery is often a treatment option for tachycardia of hormonal origin. In these cases, resection of the tumor or excision of a specific area of the endocrine gland is performed.

Cardiac surgery techniques are used for congenital cardiac pathologies - heart defects, ischemia, or for pathological consequences of systemic inflammatory processes (rheumatism).

Forecast

The prognosis is quite serious for patients with heart disease. Indeed, in this case, the presence of sinusoidal tachycardia is the body’s response to a decrease in blood output and disturbances in intracardiac and systemic hemodynamics.

With physiological tachycardia, even with pronounced signs of arrhythmia, the prognosis is favorable.

Sinus tachycardia is characterized by an increase in pulse beats up to 100 per minute. The disease is a type in which the heart rate in the sinus node is disrupted.

General characteristics, classification

There are two main types of sinus tachycardia:

If a person has increased heart contractions in the absence of any disease, then this is physiological form sinus tachycardia. Such an adaptive reaction occurs against the background of an emotional outburst and physical activity. Tachycardia can also be caused by taking certain groups of drugs. In such cases, the heartbeat rhythm is restored after calming down and resting.
If the cause of the increase in heart rate is a disease, then this pathological form tachycardia, which occurs even in a calm state, when there are no prerequisites for accelerating the rhythm.

Types of pathological sinus tachycardia:

The neurogenic type is characterized by frequent stress, which causes cardiac neurosis. In this case, an attack of tachycardia can begin even with one memory of an unpleasant situation.
The endocrine appearance occurs against the background of pathologies of the endocrine system.
The toxic form occurs with the abuse of substances such as ethyl alcohol, drugs, nicotine grass, caffeine, adrenaline or atropine. The cause may be infection of the body, in which body temperature rises and blood pressure decreases, causing anemia.
The cardiogenic type develops due to the presence of diseases of the cardiovascular system.
Orthostatic appearance occurs with prolonged bed rest or certain disorders in the nervous system. Heart contractions increase when getting out of bed, that is, from a horizontal to a vertical position.

Causes

Causes of the physiological type of sinus tachycardia:

active sports, physical activity;
mental overstrain, manifestation of emotions: fears, worries, worries, stress;
being in a stuffy room;
sudden temperature change;
air temperature is too high.

Causes of the pathological type of sinus tachycardia:

from the cardiovascular system: heart disease, chronic and acute heart failure, ischemia, heart attack, cardiosclerosis, aneurysm, atherosclerosis, hypertension, cardiomyopathy;
from the endocrine system: thyrotoxicosis, hormonal imbalance, hormone-producing neoplasm in the adrenal glands;
from the nervous system: neurosis, psychosis, vegetative-vascular dystonia;
from the respiratory system: bronchial asthma, bronchitis, pneumonia, emphysema;
blood loss and severe anemia;
infection of the body;
high body temperature, low blood pressure;
obesity;
partial dehydration;
a sharp decrease in blood glucose levels;
taking hormonal drugs, antidepressants, antihypertensive drugs, adrenergic agonists, aminophylline group, caffeine-containing medications.

Quite often, sinus tachycardia occurs due to abuse, smoking, taking drugs, drinking strong tea and coffee. At the initial stages, this seems harmless, because tachycardia has a physiological form. But over time, concomitant pathologies arise that are considered life-threatening.

The main symptoms are:

increased pulse and heartbeat: the patient may notice a fluttering of the heart and at the same time feel discomfort in the sternum;
a feeling of lack of air, which causes shortness of breath;
, up to fainting and loss of consciousness;
fatigue and weakness, even with little physical activity;
with diseases of the heart and circulatory system, pain always occurs in the chest area;
insomnia and anxiety;
increased irritability or, conversely, depression;
twitching in the limbs;
paleness of the skin;
a sharp drop in blood pressure and panic attack;
decrease in the amount of urinary fluid produced.

Only with sinus tachycardia does the attack begin slowly, which makes it difficult to determine the exact time of the heart rhythm failure. Symptoms increase gradually and the longer it occurs, the more pronounced the symptoms.

Diagnostics

Diagnostic measures for suspected sinus tachycardia are as follows:

after the patient contacts the clinic, the doctor will collect an anamnesis;
Blood pressure must be measured and the number of heart contractions determined;
the patient takes blood tests for a hematology test;
the cardiologist will prescribe auscultation, which will detect a heart murmur;
electrocardiography, which helps determine the strength, frequency, and rhythm of heart contractions;
if cardiac pathologies are suspected, echocardiography and ultrasound examination of the heart are performed, due to which all pathological abnormalities are detected;
to eliminate the risk or confirm the presence of a hormonal etiology for the occurrence of sinus tachycardia, a urine test is taken;
it is possible to perform bicycle ergometry to study the heart: for this, an exercise bike is used that records heart rate readings after and during physical activity;
EEG (electroencephalography) is used to study the central nervous system.

Drug therapy includes the following steps:

taking antiarrhythmic drugs to reduce the number of heart contractions: Verapamil, Propranolol, Flecainide, Adenosine;
beta receptor blockers: Atenolol, Timolol, Esmolol;
to stabilize sleep and calm the nervous system, sedatives and tranquilizers are prescribed;
to normalize the mineral content for adequate heart function, the doctor prescribes potassium and magnesium supplements;
Calcium antagonists and cardioselective beta blockers may also be prescribed.

Additionally, therapy is used to eliminate the underlying cause. For example, for thyrotoxicosis, drugs intended to treat the endocrine system are used. The patient must definitely change his lifestyle by excluding certain foods from the diet and getting rid of bad habits. A nutritionist should prescribe. In many cases, the patient must visit a physical therapy office and engage in moderate exercise.

Surgery used in cases where drug therapy does not produce a positive result. Catheter ablation is used, in which the sinus node is destroyed. An electrical pacemaker is installed in its place. If sinus tachycardia occurs against the background of serious heart pathologies, an appropriate operation is performed.

Folk remedies are always included in the complex treatment of any tachycardia, because they contain completely safe components. But you can use traditional medicine recipes only after the permission of the attending physician, because Not every product is ideal for a particular case.

When treating sinus tachycardia, the following recipes are effective:

Decoctions of medicinal herbs. Pharmaceutical chamomile, valerian, mint, lemon balm and motherwort must be present. To prepare a mixed decoction, you need to combine all the ingredients in equal quantities, take 1 tbsp. l. mixture and pour a glass of boiling water over it. Let it brew, take 100 ml three times a day.
Mint and lemon balm are used as a sedative. Herbs can be combined or brewed separately. Prepare and drink as a tea drink.
Make an alcohol tincture from lemon balm. For 50 grams of dry leaves you will need 125 ml of food alcohol. Combine the ingredients and pour into a glass container with a tight-fitting lid. Leave for about 2 weeks. Then the tincture should be strained and taken daily, a teaspoon three times a day. If you find it unpleasant to take such liquid in its pure form, you can add the tincture to natural juice.
Buy valerian root and calendula herb at the pharmacy. Combine in equal proportions, pour 1 tbsp. l. mixture with a glass of boiling water. Leave for 20-30 minutes and drink 50 ml 2 times a day.
Take 1 tbsp. l. coriander, pour boiling water. Leave for 2-3 hours, preferably in a thermos. Take 1 tbsp. l. twice a day.
Brew oregano and motherwort. The recipe is indicated on the pharmacy packaging.
Boil the rose hips. For 400 ml of water you will need a couple of tablespoons of fruit. Drink as a compote throughout the day.
You can brew hawthorn in the same way.
A universal recipe that is used for all pathologies of the cardiovascular system. Wash 0.5 kg of lemons. Cut the fruit to remove the seeds. Without removing the zest, pass through a meat grinder. Add a glass of natural honey and, if desired, some almonds. For 3 weeks, take the mixture 1 tbsp. l. 2-3 times a day. The first dose must be on an empty stomach. Remember that if the acidity of the gastric juice is high, this remedy is not recommended.
Black radish juice combined with the same amount of liquid honey helps. Take 1 tablespoon 2 times a day.

Prognosis, complications

With sinus tachycardia, if it is treated in a timely manner, the prognosis is quite favorable, and the quality of life does not change. However, the prognosis largely depends on the cause of tachycardia. Thus, with heart failure and other pathologies of the heart and blood vessels, death is possible.

If you do not receive timely treatment, the following complications are possible:

development of heart diseases (failure, stroke, heart attack, etc.);
severe swelling in the lungs;
arrhythmic shock;
cardiac and respiratory arrest;
thrombophlebitis, thromboembolism, atherosclerosis;
local or partial damage to parts of the brain, followed by dementia and death.

Prevention

The following should be done as preventive measures:

Strengthen your immune system, as the speed of development of pathologies depends on it. To do this, your daily diet should include healthy vitamins and minerals.
You need to eat right, excluding spicy, over-salted, fried, smoked foods.
Do moderate physical exercise, which will prevent stagnation in the internal systems of the body. This prevents the development of many diseases.
Drink at least one and a half liters of water a day.
Stop smoking and drinking alcoholic beverages.
Pay attention to any deterioration in your health in a timely manner and go to the hospital immediately. This will eliminate the risk of developing sinus tachycardia.

Preventive measures are necessary not only to prevent the formation of tachycardic attacks, but also after undergoing therapeutic measures to eliminate the disease.

Sinus tachycardia can be fraught with a number of serious complications, so it is important to diagnose it in a timely manner in order to prescribe adequate treatment. If you are predisposed to this pathology, you should visit a cardiologist annually and follow preventive measures.

General information

– a type of arrhythmia characterized by a heart rate of more than 90 beats per minute. Tachycardia is considered a normal variant when physical or emotional stress increases. Pathological tachycardia is a consequence of diseases of the cardiovascular or other systems. Manifested by a feeling of palpitations, pulsation of the vessels of the neck, anxiety, dizziness, fainting. May lead to the development of acute heart failure, myocardial infarction, ischemic heart disease, and cardiac arrest.

The development of tachycardia is based on increased automatism of the sinus node, which normally sets the pace and rhythm of heart contractions, or ectopic centers of automatism.

A person’s feeling of their heartbeat (faster and stronger heart contractions) does not always indicate a disease. Tachycardia appears in healthy people during physical activity, stressful situations and nervous excitability, with a lack of oxygen and elevated air temperatures, under the influence of certain medications, alcohol, coffee, with a sharp change in body position from horizontal to vertical, etc. Tachycardia in children younger 7 years is considered the physiological norm.

The appearance of tachycardia in practically healthy people is associated with physiological compensatory mechanisms: activation of the sympathetic nervous system, the release of adrenaline into the blood, leading to an increase in heart rate in response to the influence of an external factor. As soon as the effect of the external factor stops, the heart rate gradually returns to normal. However, tachycardia often accompanies the course of a number of pathological conditions.

Classification of tachycardia

Taking into account the reasons that caused the increase in heart rate, physiological tachycardia is distinguished, which occurs during normal heart function as an adequate response of the body to certain factors, and pathological, which develops at rest due to congenital or acquired cardiac or other pathology.

Pathological tachycardia is a dangerous symptom, because it leads to a decrease in the volume of blood ejection and other disorders of intracardiac hemodynamics. When the heart beats too fast, the ventricles do not have time to fill with blood, cardiac output decreases, blood pressure drops, and the flow of blood and oxygen to the organs, including the heart itself, weakens. A long-term decrease in the efficiency of the heart leads to arrhythmogenic cardiopathy, impaired cardiac contractility and an increase in its volume. Poor blood supply to the heart increases the risk of coronary artery disease and myocardial infarction.

According to the source generating electrical impulses in the heart, tachycardia is distinguished:

sinus - develops with an increase in the activity of the sinus (sinoatrial) node, which is the main source of electrical impulses that sets the normal heart rhythm;
ectopic (paroxysmal) tachycardia, in which the rhythm generator is located outside the sinus node - in the atria (supraventricular) or ventricles (ventricular). Usually occurs in the form of attacks (paroxysms), which begin and stop suddenly, lasting from several minutes to several days, while the heart rate remains constantly high.

Sinus tachycardia is characterized by an increase in heart rate to 120–220 beats per minute, a gradual onset and a regular sinus heart rate.

Causes of sinus tachycardia

Sinus tachycardia occurs in different age groups, more often in healthy people, as well as among patients with heart and other diseases. The occurrence of sinus tachycardia is promoted by intracardial (cardiac) or extracardial (extracardiac) etiological factors.

Sinus tachycardia in patients with cardiovascular disease is most often an early symptom of heart failure or left ventricular dysfunction. Intracardial causes of sinus tachycardia include: acute and congestive chronic heart failure, myocardial infarction, severe angina, myocarditis of rheumatic, toxic-infectious and other origins, cardiomyopathy, cardiosclerosis, heart defects, bacterial endocarditis, exudative and adhesive pericarditis.

Physiological extracardiac causes of sinus tachycardia may include physical activity, emotional stress, and congenital characteristics. Neurogenic tachycardias make up the majority of extracardiac arrhythmias and are associated with primary dysfunction of the cerebral cortex and subcortical nodes, as well as disorders of the autonomic nervous system: neuroses, affective psychoses (emotional tachycardia), neurocirculatory dystonia. Neurogenic tachycardias most often affect young people with a labile nervous system.

Among other factors of extracardiac tachycardia, there are endocrine disorders (thyrotoxicosis, increased production of adrenaline in pheochromocytoma), anemia, acute vascular insufficiency (shock, collapse, acute blood loss, fainting), hypoxemia, acute pain attacks (for example, with renal colic).

The appearance of tachycardia can be caused by fever that develops with various infectious and inflammatory diseases (pneumonia, tonsillitis, tuberculosis, sepsis, focal infection). An increase in body temperature by 1°C leads to an increase in heart rate, compared to normal, in a child by 10-15 beats per minute, and in an adult by 8-9 beats per minute.

Pharmacological (drug-induced) and toxic sinus tachycardia occurs when the function of the sinus node is influenced by drugs and chemicals: sympathomimetics (adrenaline and norepinephrine), vagolytics (atropine), aminophylline, corticosteroids, thyroid-stimulating hormones, diuretics, antihypertensive drugs, caffeine (coffee, tea) , alcohol, nicotine, poisons (nitrates), etc. Some substances do not have a direct effect on the function of the sinus node and cause so-called reflex tachycardia by increasing the tone of the sympathetic nervous system.

Sinus tachycardia can be adequate or inadequate. Inappropriate sinus tachycardia can persist at rest, unaffected by exercise or medication, and be accompanied by sensations of palpitations and shortness of breath. This is a fairly rare and little-studied disease of unknown origin. Presumably, it is associated with a primary lesion of the sinus node.

Symptoms of sinus tachycardia

The presence of clinical symptoms of sinus tachycardia depends on the degree of its severity, duration, and the nature of the underlying disease. With sinus tachycardia, subjective symptoms may be absent or minor: palpitations, discomfort, a feeling of heaviness or pain in the heart area. Inappropriate sinus tachycardia can be manifested by persistent palpitations, a feeling of shortness of breath, shortness of breath, weakness, and frequent dizziness. Fatigue, insomnia, decreased appetite, decreased performance, and worsened mood may occur.

The degree of subjective symptoms is dictated by the underlying disease and the sensitivity threshold of the nervous system. In case of heart disease (for example, coronary atherosclerosis), an increase in the number of heart contractions can cause attacks of angina pectoris, worsening the symptoms of heart failure.

With sinus tachycardia, there is a gradual onset and end. In the case of severe tachycardia, symptoms may reflect disturbances in the blood supply to various organs and tissues due to a decrease in cardiac output. Dizziness and sometimes fainting appear; with damage to cerebral vessels - focal neurological disorders, convulsions. With prolonged tachycardia, there is a decrease in blood pressure (arterial hypotension), a decrease in diuresis, and coldness of the extremities is observed.

Diagnosis of sinus tachycardia

Diagnostic measures are carried out to identify the cause (cardiac damage or extracardiac factors) and differentiate sinus and ectopic tachycardia. The ECG plays a leading role in the differential diagnosis of the type of tachycardia, determining the frequency and rhythm of heart contractions. Daily Holter ECG monitoring is highly informative and absolutely safe for the patient; it identifies and analyzes all types of heart rhythm disturbances, changes in heart activity during the patient’s normal activity.

EchoCG (echocardiography), MRI of the heart (magnetic resonance imaging) are carried out to identify intracardiac pathology that causes pathological tachycardia EPI (electrophysiological study) of the heart, studying the propagation of an electrical impulse through the heart muscle, allows us to determine the mechanism of tachycardia and cardiac conduction disorders. Additional research methods (general blood count, determination of the content of thyroid-stimulating hormones in the blood, EEG of the brain, etc.) make it possible to exclude blood diseases, endocrine disorders, pathological activity of the central nervous system, etc.

Treatment of sinus tachycardia

The principles of treatment of sinus tachycardia are determined, first of all, by the causes of its occurrence. Treatment should be carried out by a cardiologist together with other specialists. It is necessary to eliminate factors that contribute to an increase in heart rate: eliminate caffeine-containing drinks (tea, coffee), nicotine, alcohol, spicy foods, chocolate; protect yourself from psycho-emotional and physical overload. For physiological sinus tachycardia, no treatment is required.

Treatment of pathological tachycardia should be aimed at eliminating the underlying disease. In case of extracardiac sinus tachycardia of a neurogenic nature, the patient needs to consult a neurologist. Treatment uses psychotherapy and sedatives (luminal, tranquilizers and antipsychotics: mebicar, diazepam). In the case of reflex tachycardia (with hypovolemia) and compensatory tachycardia (with anemia, hyperthyroidism), it is necessary to eliminate the causes that caused them. Otherwise, therapy aimed at reducing heart rate can lead to a sharp decrease in blood pressure and aggravate hemodynamic disorders.

For sinus tachycardia caused by thyrotoxicosis, β-blockers are used in addition to the thyreostatic drugs prescribed by the endocrinologist. Preference is given to β-blockers of the oxyprenolol and pindolol group. If there are contraindications to β-blockers, alternative medications are used - non-hydropyridine calcium antagonists (verapamil, diltiazem).

For sinus tachycardia caused by heart failure, cardiac glycosides (digoxin) are prescribed in combination with beta-blockers. The target heart rate should be selected individually, depending on the patient’s condition and his underlying disease. The target resting heart rate for angina is usually 55-60 beats per minute; for neurocirculatory dystonia - 60 - 90 beats per minute, depending on subjective tolerance.

With paroxysmal tachycardia, increasing the tone of the vagus nerve can be achieved with a special massage - pressing on the eyeballs. If there is no effect, an antiarrhythmic drug (verapamil, amiodarone, etc.) is administered intravenously. Patients with ventricular tachycardia require emergency care, emergency hospitalization and anti-relapse antiarrhythmic therapy.

In case of inadequate sinus tachycardia, in case of ineffectiveness of b-blockers and in case of significant deterioration of the patient's condition, transvenous RFA of the heart is used (restoration of normal heart rhythm by cauterization of the affected area of the heart). If there is no effect or the patient’s life is threatened, a surgical procedure is performed to implant an electrical pacemaker (ECS) - an artificial pacemaker.

Forecast and prevention of sinus tachycardia

Sinus tachycardia in patients with heart disease is most often a manifestation of heart failure or left ventricular dysfunction. In these cases, the prognosis can be quite serious, since sinus tachycardia is a reflection of the reaction of the cardiovascular system to a decrease in ejection fraction and a disorder of intracardiac hemodynamics. In the case of physiological sinus tachycardia, even with pronounced subjective manifestations, the prognosis is usually satisfactory.

Prevention of sinus tachycardia consists of early diagnosis and timely treatment of cardiac pathology, elimination of extracardiac factors that contribute to the development of disturbances in heart rate and sinus node function. To avoid serious consequences of tachycardia, it is necessary to follow recommendations for a healthy lifestyle.

Rapid heartbeat - is it dangerous or not? It all depends on what caused the increase in heart rate. It’s one thing if the attack began after a fright, and another when there are chronic diseases.

So, let's figure out what it is - sinus tachycardia of the heart, is it dangerous and why, what are its symptoms and what is the treatment.

Sinus tachycardia is a form of arrhythmia, what does it mean? This type of tachycardia is caused by a disorder:

generation of impulses by the sinus node, which controls heart rhythm;
conduction of impulses from the sinus node to the ventricles.

The sinus node is the part of the heart in which sinus rhythm is formed. There, a wave of excitation arises, which spreads to the heart and contributes to its synchronous functioning.

In adults the limiting norm is considered to be a heart rate (HR) of 100 beats per minute. For children, this indicator is calculated by age, and a deviation is considered to be an excess of heart rate by 10% of the age norm.

With sinus tachycardia, the heart rate is 95–130 beats per minute (without physical activity), 150–160 - with load. For athletes, this figure can reach 180–240 beats.

Forms

There are functional and pathological (or long-term) forms.

Functional

Functional is understood as an acceleration of sinus rhythm in response to stress (physical or emotional) or fever. The heart rate returns to normal as soon as the cause is eliminated.

Pathological

The pathological form occurs at rest. It is caused by extracardial and intracardial factors.

Differences from other species

There are also paroxysmal tachycardia and ventricular fibrillation.

It differs from sinus tachycardia in that in the first case the attack begins suddenly, Heart rate is 120–250 beats per minute, while maintaining the correct rhythm during the attack.

With physiological sinus tachycardia, heart rate increases smoothly; the paroxysmal form is characterized by suddenness.

Ventricular fibrillation is a life-threatening condition in which blood is not ejected from the heart and the organ stops working. In this case, a chaotic contraction of myocardial fibers occurs (250–480 beats per minute).

Usually the symptom occurs as a complication, as well as due to shock and severe potassium deficiency in the blood.

Ventricular fibrillation requires urgent medical attention!

Development mechanism

Sinus tachycardia develops according to one of the scenarios:

Activation of the symptomatic system, which is part of the nervous system. The substance norepinephrine from nerve fibers activates the sinus node.
Decreased activity of the parasympathetic system. Its substance acetylcholine inhibits the generation of impulses, which leads to a decrease in heart rate. When the activity of the parasympathetic system decreases, the role of the sympathetic system increases, resulting in an increase in heart rate.
Direct impact of influencing factors on the sinoatrial node during normal functioning of the sympathetic and parasympathetic nervous system. Active substances act on impulse-generating cells and excite them.

Causes

Symptom occurs more often in young people. The reason for this is the immaturity of the nervous system. The body needs a balance of the sympathetic and parasympathetic nervous systems. But at a young age, the balance is poorly maintained, so imbalances arise, which causes an attack (cardioneurosis).

Various factors contribute to the development of sinus tachycardia. Physiological form - reaction to stress, stress, high temperature. As for pathological TS, a distinction is made between extracardiac and intracardial groups of factors.

Extracardiac factors include:

Neurogenic- develops in individuals (more often in young women) with an unstable nervous system, with a tendency to neuroses, depression, etc., which is explained by the high sensitivity of heart receptors to stress hormones.
Toxic- caused by toxic substances - alcohol, tobacco, as well as internal factors (thyrotoxicosis, adrenal tumor - pheochromocytoma, more common in women), chronic infections (tuberculosis, tonsillitis).
Drug- occurs due to activity or overdose. This is how hormonal drugs, drugs for the treatment of lung diseases, hypertension, and antidepressants affect the body.
Hypoxic- this is how the body reacts to oxygen deficiency. In turn, the cause of hypoxia is diseases of the respiratory system and blood pathologies, in which the delivery of gas to organs and systems is disrupted (anemia, leukemia, chronic blood loss, etc.).

Intracardiac factors are caused by heart disease. Often (but not always) the development of sinus tachycardia in people with heart disease indicates heart failure or impaired left ventricular function, since then there is a decrease in ejection fraction or a clinically significant deterioration of hemodynamics within the heart.

Most often, the intracardial form of TS develops with the following pathologies:

chronic heart failure;
with ischemic heart disease;
cardiomyopathy;

Find out more about the disease from the video:

Symptoms

During an attack of sinus tachycardia in a patient The following symptoms may appear:

“fluttering” of the heart, rapid heart rate;
dyspnea;
heaviness, “tightness” in the chest (occurs when there is no load);
dizziness, loss of consciousness;
compressive chest pain (no longer than 5 minutes) - with coronary heart disease;
general weakness, decreased performance, intolerance to physical activity (in the pathological form).

Functional TS usually does not require medical intervention and goes away after the provoking factor is eliminated. However, manifestations such as chest pain and loss of consciousness are a reason to urgently consult a doctor.

Diagnostics

A complete picture of the severity of the condition is obtained after the examination. Diagnostic activities include:

anamnesis analysis- the patient is asked to describe sensations, possible cause-and-effect relationships, the presence of chronic diseases, living conditions, bad habits, etc.;
physical examination- examine the skin, study the condition of hair and nails;
auscultation- the respiratory rate, wheezing and heart murmurs are determined, which makes it possible to identify the cause of the pathology;
- shows anemia, leukocyte level (increases with chronic disease);
- gives an idea of the level of cholesterol (low and high density), glucose, potassium, creatine, urea, allows you to exclude diabetes, kidney disease, changes in the chemical composition of the blood;
urine test (general)- excludes diseases of the urinary tract;
hormonal analysis- to determine the level of hormones produced by the thyroid gland;
echocardiography() - detects structural changes.

The main and most informative study is, or ECG, as well (recording is carried out continuously for 24–72 hours, at rest and during exercise).

ECG signs of sinus tachycardia are presented in this illustration:

The patient is prescribed consultations with a psychotherapist, otolaryngologist, and other specialists.

How and with what to treat

The main goal of treatment is to eliminate the cause of the attacks, since sinus angina is a symptom of other ailments. Therapy is selected and prescribed by a cardiologist.

Correction of daily routine and habits

This block of activities includes:

giving up bad habits - drinking alcohol, drugs, smoking;
diet correction - patients are advised to eat foods rich in fiber and give up fatty, hot, spicy foods, reduce the amount of coffee and tea;
adherence to sleep and rest patterns.

Elimination of chronic diseases

If the examination reveals that the cause of tachycardia is an infection, then treatment is aimed at eliminating it. The patient is prescribed sanitation for diseases of the oral cavity, removal of a diseased tooth or inflamed tonsils, antibiotic therapy.

Indicated for iron deficiency and anemia taking medications with this element, in case of bleeding - the introduction of solutions in order to restore the volume of the blood mass.

Lack of oxygen due to bronchopulmonary diseases is eliminated by introducing gas through a catheter into the nasal passages.

Prescribed drugs

Medicines to eliminate the tachycardia itself are prescribed when the patient cannot tolerate the rapid heartbeat. For sinus tachycardia, the following drugs are used:

beta blockers- block receptors that respond to stress hormones adrenaline and norepinephrine;
if channel inhibitors- control the degree of excitation in the sinus node, heart rate;
sedatives based on medicinal plants - motherwort, valerian root, hawthorn.

Recovery

The patient may be indicated for spa treatment in Kislovodsk and other health resorts if the cause is intracardial factors. In other cases, rehabilitation measures depend on the underlying disease.

eliminate intense emotional stress - at home and at work;
sleep 8 hours a day;
eat right, avoiding spicy and fatty foods;
eat vegetables, herbs, fish (especially sea fish) every day;
give up bad habits;
do gymnastics (at least 30 minutes daily);
control body weight.

Controversial techniques

Doctors argue about is it possible to take cardiac glycosides with sinus tachycardia. This applies in particular to digoxin. According to the Russian method, a combination of beta blockers and digoxin, sometimes with calcium antagonists, achieves clear control over heart rate.

The range of drugs for the treatment of tachycardia is limited, since it may have side effects with long-term therapy. If drug therapy is not possible, resort to electrical stimulation of the myocardium.

Sinus tachycardia in the elderly is treated surgically, with pacemakers installed, which eliminates the blockade of the atrioventricular node.

Forecast

The prognosis is quite serious if sinus tachycardia is a symptom of heart failure or left ventricular dysfunction. Then the course of the disease worsens.

It's important to remember that sinus tachycardia may be a manifestation of other ailments. But in childhood, pregnancy and adolescence this is often the norm. Then the medications can be harmful.

Therefore, taking any action on your own is prohibited. Only a specialist can determine the degree of danger and the advisability of prescribing medications after an extensive examination.

Sinus tachycardia is a disease in which the heart rate increases, which occurs against the background of active work of the sinus node. This condition is typical for both adults and children. A wide range of predisposing factors can cause the development of such a disorder, which are not always associated with the course of any other disease. The source can also be severe stress or excessive physical activity.

The disease has characteristic symptoms, including pain in the chest area, a person’s sense of their own heart rate, weakness and severe dizziness.

To make a correct diagnosis, a whole range of measures is required - from a physical examination performed by a cardiologist to instrumental examinations of the patient.

The disease can be cured using conservative methods, which boil down to physiotherapeutic procedures, taking medications and following a gentle diet.

The International Classification of Diseases, Tenth Revision, classifies this disorder as supraventricular tachycardia. It is worth noting that this is a clarified name for a similar pathology. Thus, sinus tachycardia code according to ICD-10 is as follows – I 47.1.

Etiology

The correct heart rhythm directly depends on how evenly impulses arise in the sinus node and are carried through the fiber system. The sinus node is a collection of nerve cells that are localized in the atrium.

Normally, the optimal values for sinus rhythm are the number of contractions, which range from sixty to ninety beats per minute. It follows from this that sinus tachycardia is nothing more than an increase in heart rate over 90 times per minute. It is worth noting that in children, such a disorder is diagnosed if the heart rate increases by more than 10% of the norm characteristic of a particular age.

This pathology occurs in any age category, in the vast majority of cases in healthy people, as well as among those diagnosed with heart disease. Given that the disease develops due to a large number of factors, they are usually divided into several groups - pathological and not related to the course of a particular disease.

in acute or chronic form;
dysfunction of the left ventricle of the heart;
severe course;
any nature of occurrence;
the presence of a person or;
or ;
exudative or adhesive in nature;
primary disruption of the normal functioning of the cerebral cortex or subcortical nodes;
pathologies of the endocrine system;

Physiological predisposing sources of the formation of sinus tachycardia of the heart are presented:

excessive physical exertion - the permissible values can be no more than 160 beats per minute, the rest, higher indicators, belong to this variety. It is worth noting that the only exception is professional athletes - heart rate can reach 240 beats per minute - only in such cases there is no need for emergency care;
prolonged exposure to stressful situations or one-time severe nervous strain;
addiction to bad habits;
irrational use of medications, for example, glucocorticoids, antidepressants, calcium antagonists, diuretics, substances containing caffeine, as well as medications aimed at treatment.

In addition, it should be noted that an increase in heart rate can be affected by an increase in body temperature. Each increase in the thermometer value by one division leads to the fact that the heart rate in a child increases by about 15 beats per minute, and in an adult - by 9.

The causes of sinus tachycardia in women can be:

the period of bearing a child - despite the fact that sinus tachycardia is a normal phenomenon in pregnant women, it can develop against the background of pathological causes, which is why the appearance of symptoms of the disease should be the impetus for seeking qualified help;
the course of menstruation;
hot flashes observed with, as well as any other hormonal disorders.

In childhood, such a disorder may be an individual norm. It is noteworthy that it is most often observed in girls.

Classification

The main division of sinus tachycardia in a child or adult divides the disease into:

functional– is such in cases of influence on the human body by strong emotions or physical activity, as well as an increase in temperature;
pathological– also called prolonged sinus tachycardia.

Forms of long-term varieties of the disease depending on the etiological factor:

neurogenic– develops due to an unstable or labile nervous system;
toxic– is caused by the negative impact of toxic substances on the body;
medicinal;
endocrine;
hypoxic– represents the body’s natural response to lack of oxygen;
myogenic– formed against the background of cardiac pathologies.

Separately, it is worth highlighting orthostatic or vertical sinus tachycardia. This means that a heart rate disturbance is observed when the body moves from a lying to a standing position.

There are also three degrees of severity of the disease:

mild sinus tachycardia– does not provide for any specific therapy;
moderate sinus tachycardia– often occurs in children under six years of age, as well as in adolescents during puberty. This variety should not cause concern, since its symptoms are completely absent or mild;
severe sinus tachycardia– most often appears in older people, but can also occur in children. In such cases, the alternation of a rapid pulse with a condition such as bradycardia, in which the heart rate is reduced, is considered dangerous. This combination requires urgent emergency care.

Symptoms

The presence and severity of symptoms of this pathology depends on several factors:

severity of sinus tachycardia;
duration;
predisposing factor.

With a mild course of the disease, symptoms are completely absent, which is why a person may not even suspect that he has such a disorder.

Moderate sinus tachycardia can also be completely asymptomatic, but sometimes the signs may be minor. These include:

feeling your own heartbeat;
discomfort and stiffness in the chest area;
shortness of breath;
sleep disturbance;
fatigue;
frequent mood swings.

Symptoms of severe sinus tachycardia, in addition to increasing the severity of the above clinical manifestations, have the following signs:

frequent and severe dizziness;
intense pain in the heart area;
lack of air;
the appearance of shortness of breath at rest;
complete lack of sleep;
loss of appetite or complete aversion to food;
fainting;
decreased blood pressure;
cold extremities;
reduction in the daily volume of urine excreted.

It is worth noting that this is only the main symptomatology of sinus tachycardia, which will be supplemented by the clinical manifestations of the disease against which such a disorder developed.

All of the above symptoms are characteristic of both adults and children, but in the second case the disease will be much more severe. It is for this reason that there are several emergency rules aimed at reducing heart rate, including:

calling a medical team to your home;
pressing on the area of the carotid node;
massaging both eyeballs in a circular motion;
straining when taking a deep breath with your nose pinched;
compression of the upper abdomen;
pressing the lower extremities towards the anterior wall of the abdominal cavity;
cold rubdowns.

Such measures should alleviate the patient’s condition before the doctors arrive.

Ignoring the symptoms can lead to heart failure or the consequences of the disease that led to such a heart rate disturbance - this is what sinus tachycardia is dangerous for.

Diagnostics

Despite the fact that this disease has quite specific symptoms, in order to make a diagnosis of sinus tachycardia, it is necessary to perform a whole range of diagnostic measures.

First of all, the cardiologist needs to:

study the patient’s medical history and life history - in some cases this will help to establish the most likely causes of sinus tachycardia in a particular person;
conduct a thorough physical examination aimed at studying the condition of the skin, assessing the frequency of respiratory movements and listening to the patient using special instruments;
interview the patient or his parents in detail to establish the severity of symptoms and determine the severity of the disease.

Laboratory tests include:

general clinical blood test - to identify possible anemia and the course of ailments that could cause sinus tachycardia;
general urine analysis;
blood biochemistry - for the final identification of the provoking disease;
blood test for thyroid hormones.

The most valuable in diagnostic terms are the following instrumental examinations:

In addition, consultation may be needed:

pediatrician - if the patient is a child;
psychotherapist;
otolaryngologist;
endocrinologist;
obstetrician-gynecologist - in cases of detection of sinus tachycardia during pregnancy.

Only after studying the results of all diagnostic measures, the cardiologist will draw up an individual scheme for each patient on how to treat sinus tachycardia.

Treatment

Therapy for such a disease is based on eliminating the cause of its occurrence. Therefore, treatment may include:

rejection of bad habits;
balanced diet;
good sleep;
taking antibacterial agents - during infectious diseases;
the use of drugs that suppress the active functioning of the thyroid gland;
taking iron supplements internally;
intravenous administration of special solutions that restore the full volume of circulating blood;
oxygen therapy - to eliminate diseases of the bronchi or lungs;
psychotherapy or auto-training.

Direct treatment of sinus tachycardia with medications is necessary only in cases where the patient has difficulty with palpitations. To do this, patients are recommended to take:

beta blockers;
sinus node if-channel inhibitors;
tinctures based on plants such as valerian root, hawthorn or motherwort.

If the disease is severe in a woman during pregnancy, urgent stimulation of labor is necessary. Often, childbirth with sinus tachycardia is carried out by cesarean section.

The only consequence of this disease is the development of heart failure.

Prevention and prognosis

To prevent people from developing paroxysmal sinus tachycardia, the following general recommendations must be followed:

complete abstinence from alcohol and nicotine;
proper nutrition, enriched with vitamins and microelements necessary for the body;
avoiding emotional and physical fatigue;
body weight control;
maintaining a moderately active lifestyle;
ensuring sufficient sleep;
timely diagnosis and treatment of cardiac pathologies;
taking medications strictly according to the instructions of the attending physician;
Regularly undergoing a full examination at a medical institution.

Physiological sinus tachycardia often has a favorable prognosis, but only if complex therapy is started in a timely manner. If the disease was caused by other ailments, then there is a high probability of developing life-threatening consequences.