Inappropriate sinus tachycardia: Difference between revisions
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{{SI}} | |||
{{Infobox medical condition | |||
| name = Inappropriate sinus tachycardia | |||
| image = [[File:ECG_Sinus_Tachycardia_132_bpm.jpg|left|thumb|ECG showing sinus tachycardia]] | |||
| caption = ECG showing sinus tachycardia | |||
| field = [[Cardiology]] | |||
| symptoms = [[Palpitations]], [[dizziness]], [[fatigue]], [[shortness of breath]] | |||
| onset = Typically [[adulthood]] | |||
| duration = [[Chronic (medicine)|Chronic]] | |||
| causes = Unknown, possibly [[autonomic nervous system]] dysfunction | |||
| risks = [[Female]] gender, [[anxiety]], [[stress]] | |||
| diagnosis = [[Electrocardiogram|ECG]], [[Holter monitor]], [[tilt table test]] | |||
| differential = [[Sinus tachycardia]], [[postural orthostatic tachycardia syndrome]], [[anxiety disorder]] | |||
| treatment = [[Beta blocker]]s, [[ivabradine]], [[lifestyle modification]] | |||
| prognosis = Variable, often manageable with treatment | |||
| frequency = Rare | |||
}} | |||
'''Inappropriate Sinus Tachycardia (IST)''' is a clinical syndrome characterized by a persistently elevated heart rate (HR) at rest, with minimal physical or emotional stress, and without a secondary cause. It is distinguished by an inappropriately high resting heart rate or disproportionate increase in heart rate with minimal exertion. The condition is diagnosed when the resting heart rate is consistently above 100 beats per minute (bpm) or there is a disproportionate heart rate response to minimal or moderate activity, in the absence of other causes of tachycardia such as [[Heart Failure|heart failure]], [[Fever|fever]], or [[Hyperthyroidism|hyperthyroidism]]. | '''Inappropriate Sinus Tachycardia (IST)''' is a clinical syndrome characterized by a persistently elevated heart rate (HR) at rest, with minimal physical or emotional stress, and without a secondary cause. It is distinguished by an inappropriately high resting heart rate or disproportionate increase in heart rate with minimal exertion. The condition is diagnosed when the resting heart rate is consistently above 100 beats per minute (bpm) or there is a disproportionate heart rate response to minimal or moderate activity, in the absence of other causes of tachycardia such as [[Heart Failure|heart failure]], [[Fever|fever]], or [[Hyperthyroidism|hyperthyroidism]]. | ||
==Etiology== | ==Etiology== | ||
The exact cause of IST is not well understood, but it is thought to involve dysregulation of the autonomic nervous system, which controls the heart rate. Some theories suggest an intrinsic abnormality in the sinus node (the heart's natural pacemaker), while others propose an exaggerated response to normal sympathetic stimulation. There is also evidence to suggest a genetic predisposition in some cases. | The exact cause of IST is not well understood, but it is thought to involve dysregulation of the autonomic nervous system, which controls the heart rate. Some theories suggest an intrinsic abnormality in the sinus node (the heart's natural pacemaker), while others propose an exaggerated response to normal sympathetic stimulation. There is also evidence to suggest a genetic predisposition in some cases. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Patients with IST may present with a variety of symptoms, including palpitations, [[Dyspnea|dyspnea]] (difficulty breathing), [[Fatigue (medical)|fatigue]], [[Chest Pain|chest pain]], lightheadedness, and occasionally, syncope (fainting). These symptoms can significantly impair the quality of life and mimic other cardiac conditions, making the diagnosis challenging. | Patients with IST may present with a variety of symptoms, including palpitations, [[Dyspnea|dyspnea]] (difficulty breathing), [[Fatigue (medical)|fatigue]], [[Chest Pain|chest pain]], lightheadedness, and occasionally, syncope (fainting). These symptoms can significantly impair the quality of life and mimic other cardiac conditions, making the diagnosis challenging. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of IST is primarily clinical, based on the patient's history and physical examination. An [[Electrocardiogram|electrocardiogram]] (ECG) is essential for observing the heart rate and rhythm. Additional tests may include a 24-hour [[Holter Monitor|Holter monitor]], which records the heart's electrical activity for a full day, and an exercise stress test to evaluate the heart rate response to exercise. It is crucial to exclude secondary causes of tachycardia, which may require blood tests, imaging studies, or further cardiac evaluation. | The diagnosis of IST is primarily clinical, based on the patient's history and physical examination. An [[Electrocardiogram|electrocardiogram]] (ECG) is essential for observing the heart rate and rhythm. Additional tests may include a 24-hour [[Holter Monitor|Holter monitor]], which records the heart's electrical activity for a full day, and an exercise stress test to evaluate the heart rate response to exercise. It is crucial to exclude secondary causes of tachycardia, which may require blood tests, imaging studies, or further cardiac evaluation. | ||
==Treatment== | ==Treatment== | ||
Treatment of IST focuses on symptom relief and may include lifestyle modifications, pharmacotherapy, and in some cases, invasive procedures. Lifestyle changes such as avoiding caffeine and alcohol, engaging in regular exercise, and stress management techniques can be beneficial. Pharmacological treatment may involve beta-blockers or calcium channel blockers to control the heart rate. In refractory cases, [[Catheter Ablation|catheter ablation]] of the sinus node has been used, but its efficacy and safety are still under investigation. | Treatment of IST focuses on symptom relief and may include lifestyle modifications, pharmacotherapy, and in some cases, invasive procedures. Lifestyle changes such as avoiding caffeine and alcohol, engaging in regular exercise, and stress management techniques can be beneficial. Pharmacological treatment may involve beta-blockers or calcium channel blockers to control the heart rate. In refractory cases, [[Catheter Ablation|catheter ablation]] of the sinus node has been used, but its efficacy and safety are still under investigation. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis of IST varies. While it is not considered life-threatening, the symptoms can significantly affect the patient's quality of life. With appropriate management, many patients can achieve good symptom control and lead a normal life. However, some individuals may continue to experience symptoms despite treatment. | The prognosis of IST varies. While it is not considered life-threatening, the symptoms can significantly affect the patient's quality of life. With appropriate management, many patients can achieve good symptom control and lead a normal life. However, some individuals may continue to experience symptoms despite treatment. | ||
==Epidemiology== | ==Epidemiology== | ||
IST is more common in young women, but it can affect individuals of any age and sex. The exact prevalence is unknown due to the variability in diagnostic criteria and the overlap with other conditions. | IST is more common in young women, but it can affect individuals of any age and sex. The exact prevalence is unknown due to the variability in diagnostic criteria and the overlap with other conditions. | ||
==See Also== | ==See Also== | ||
* [[Tachycardia]] | * [[Tachycardia]] | ||
| Line 24: | Line 34: | ||
* [[Autonomic Nervous System]] | * [[Autonomic Nervous System]] | ||
* [[Electrocardiogram]] | * [[Electrocardiogram]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Arrhythmia]] | [[Category:Arrhythmia]] | ||
{{Cardiology-stub}} | {{Cardiology-stub}} | ||
==References== | ==References== | ||
<references/> | <references/> | ||
==External Links== | ==External Links== | ||
* [https://www.heart.org American Heart Association] | * [https://www.heart.org American Heart Association] | ||
* [https://www.hrsonline.org Heart Rhythm Society] | * [https://www.hrsonline.org Heart Rhythm Society] | ||
{{Medicine-stub}} | {{Medicine-stub}} | ||
Latest revision as of 21:26, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Inappropriate sinus tachycardia | |
|---|---|
 | |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Palpitations, dizziness, fatigue, shortness of breath |
| Complications | N/A |
| Onset | Typically adulthood |
| Duration | Chronic |
| Types | N/A |
| Causes | Unknown, possibly autonomic nervous system dysfunction |
| Risks | Female gender, anxiety, stress |
| Diagnosis | ECG, Holter monitor, tilt table test |
| Differential diagnosis | Sinus tachycardia, postural orthostatic tachycardia syndrome, anxiety disorder |
| Prevention | N/A |
| Treatment | Beta blockers, ivabradine, lifestyle modification |
| Medication | N/A |
| Prognosis | Variable, often manageable with treatment |
| Frequency | Rare |
| Deaths | N/A |
Inappropriate Sinus Tachycardia (IST) is a clinical syndrome characterized by a persistently elevated heart rate (HR) at rest, with minimal physical or emotional stress, and without a secondary cause. It is distinguished by an inappropriately high resting heart rate or disproportionate increase in heart rate with minimal exertion. The condition is diagnosed when the resting heart rate is consistently above 100 beats per minute (bpm) or there is a disproportionate heart rate response to minimal or moderate activity, in the absence of other causes of tachycardia such as heart failure, fever, or hyperthyroidism.
Etiology[edit]
The exact cause of IST is not well understood, but it is thought to involve dysregulation of the autonomic nervous system, which controls the heart rate. Some theories suggest an intrinsic abnormality in the sinus node (the heart's natural pacemaker), while others propose an exaggerated response to normal sympathetic stimulation. There is also evidence to suggest a genetic predisposition in some cases.
Clinical Presentation[edit]
Patients with IST may present with a variety of symptoms, including palpitations, dyspnea (difficulty breathing), fatigue, chest pain, lightheadedness, and occasionally, syncope (fainting). These symptoms can significantly impair the quality of life and mimic other cardiac conditions, making the diagnosis challenging.
Diagnosis[edit]
The diagnosis of IST is primarily clinical, based on the patient's history and physical examination. An electrocardiogram (ECG) is essential for observing the heart rate and rhythm. Additional tests may include a 24-hour Holter monitor, which records the heart's electrical activity for a full day, and an exercise stress test to evaluate the heart rate response to exercise. It is crucial to exclude secondary causes of tachycardia, which may require blood tests, imaging studies, or further cardiac evaluation.
Treatment[edit]
Treatment of IST focuses on symptom relief and may include lifestyle modifications, pharmacotherapy, and in some cases, invasive procedures. Lifestyle changes such as avoiding caffeine and alcohol, engaging in regular exercise, and stress management techniques can be beneficial. Pharmacological treatment may involve beta-blockers or calcium channel blockers to control the heart rate. In refractory cases, catheter ablation of the sinus node has been used, but its efficacy and safety are still under investigation.
Prognosis[edit]
The prognosis of IST varies. While it is not considered life-threatening, the symptoms can significantly affect the patient's quality of life. With appropriate management, many patients can achieve good symptom control and lead a normal life. However, some individuals may continue to experience symptoms despite treatment.
Epidemiology[edit]
IST is more common in young women, but it can affect individuals of any age and sex. The exact prevalence is unknown due to the variability in diagnostic criteria and the overlap with other conditions.
See Also[edit]
This article is a cardiovascular system stub. You can help WikiMD by expanding it!
References[edit]
<references/>
External Links[edit]
