Sinus tachycardia (ST) is ubiquitous, but its presence outside of normal physiological triggers in otherwise healthy individuals remains a commonly encountered phenomenon in medical practice. In many cases, ST can be readily explained by a current medical condition that precipitates an increase in the sinus rate, but ST at rest without physiological triggers may also represent a spectrum of normal. In other cases, ST may not have an easily explainable cause but may represent serious underlying pathology and can be associated with intolerable symptoms. The classification of ST, consideration of possible etiologies, as well as the decisions of when and how to intervene can be difficult. ST can be classified as secondary to a specific, usually treatable, medical condition (eg, pulmonary embolism, anemia, infection, or hyperthyroidism) or be related to several incompletely defined conditions (eg, inappropriate ST, postural tachycardia syndrome, mast cell disorder, or post-COVID syndrome). While cardiologists and cardiac electrophysiologists often evaluate patients with symptoms associated with persistent or paroxysmal ST, an optimal approach remains uncertain. Due to the many possible conditions associated with ST, and an overlap in medical specialists who see these patients, the inclusion of experts in different fields is essential for a more comprehensive understanding. This article is unique in that it was composed by international experts in Neurology, Psychology, Autonomic Medicine, Allergy and Immunology, Exercise Physiology, Pulmonology and Critical Care Medicine, Endocrinology, Cardiology, and Cardiac Electrophysiology in the hope that it will facilitate a more complete understanding and thereby result in the better care of patients with ST.
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http://dx.doi.org/10.1161/CIRCEP.121.007960 | DOI Listing |
Eur Heart J Case Rep
January 2025
Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
Background: Left bundle branch block (LBBB) is a rare conduction disorder in athletes associated with ventricular dyssynchrony, which can lead to left ventricular systolic dysfunction and exercise intolerance. Inappropriate sinus tachycardia (IST) is characterized by an excessive heart rate (HR) that is not related to physiological needs, often resulting in reduced exercise capacity. Managing these conditions in athletes can be challenging, as standard treatments like beta-blockers and ivabradine, while effective in controlling HR, are described to be associated with a reduction in maximal exercise performance.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Cardiology Department, Meir Medical Center, Tchernichovsky St 59, Kfar Saba 4418001, Israel.
Background: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA) (ALCAPA) is a rare congenital abnormality. We present a case of an ALCAPA in a 25-year-old man.
Case Summary: A 25-year-old male with no past medical history was admitted to our intensive cardiac care unit after sudden cardiac arrest due to ventricular fibrillation and suspected acute coronary syndrome.
A A Pract
January 2025
Integrated Anesthesia Associates, Department of Anesthesia, Hartford Hospital, Hartford, Connecticut.
Inappropriate sinus tachycardia (IST) presents challenges in diagnosis and treatment due to its unclear etiology and limited therapeutic options. This case report explores the use of continuous stellate ganglion block (CSGB) as a potential treatment avenue. A 23-year-old woman with refractory IST underwent several CSGB placements, resulting in prolonged symptom relief and decreased median heart rate.
View Article and Find Full Text PDFCureus
December 2024
Emergency Medicine, Memorial Healthcare System, Hollywood, USA.
A six-year-old boy presented to the pediatric emergency department following an accidental ingestion of a synthetic cannabinoid. The child ingested an edible product containing tetrahydrocannabinol (THC) and presented with lethargy, altered mental status, and increased muscle tone. The airway was protected, and the patient was breathing spontaneously.
View Article and Find Full Text PDFKardiol Pol
January 2025
Department of Cardiac Surgery and Transplantology, National Medical Institute, Ministry of Interior and Administration, Center of Postgraduate Medical Education, Warszawa, Poland.
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