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Sinus tachycardia is a condition referring to elevated heart rate (more than 100 beats per minute), with impulses originating from the sinoatrial node. The normal heart rate for an adult is 60 to 100 beats per minute (bpm), albeit it should be noted that the normal heart for adults and children do vary generally depending on fitness and activity levels. Inappropriate sinus tachycardia (IST) was first described in 1979.
Sinus tachycardia has nothing to do with a sinus infection, which is the infection of the sinus cavities in the nasal passage. It is related to the sinus node, which is a group of cells found in the upper right chamber of the heart. These cells generate electric signals that control the rhythm and pace of the heart.

Causes: Sinus tachycardia causes are often due to physiological conditions or situations such as extensive exercising or occur as result of stress, anger, or fright. The causes of sinus tachycardia could include anxiety, anemia, dehydration, heart failure, fever and hyperthyroidism. Besides these, electric shock, hypoxia, malignant hyperthermia, pulmonary embolism, hyperdynamic circulation, endocrine disorders, and cancer-related body stresses are some of the other causes. Studies have also shown that intake of stimulants like caffeine, nicotine, amphetamines or cocaine, drug withdrawal, sepsis, or chronic pulmonary disease could also result in this condition. Sinus tachycardia can occur in pregnant women too, with an increase of 10 to 20 bpm.

Symptoms: Sinus tachycardia is a symptomatic, which means that there are no obvious signs to recognize the problem. The minor symptoms include a racing heart rate, palpitations, fainting, dizziness, heart rate above 100 bpm even at rest, chest pain, chest pressure with a constraining feeling, increased fatigue, getting out of breath often, intolerance to any kind of physical activity, and general weakness.
If you experience these symptoms but are not sure of the cause, it is important to consult a doctor to determine it. It is essential not to self-medicate as it can worsen the situation.

Treatment: The treatment of sinus tachycardia lies in treating the symptoms and the causes at the same time. The course of treatment is determined based on the causes and the medical history of the patient. Treatment of sinus tachycardia is primarily done by eliminating the causes the like anemia, hyperthyroidism, volume depletion, fever, anxiety, drug use, cardiomyopathy, or pheochromocytoma. If these causes are excluded, the patient is monitored and tested through treadmill stress test.

• Drugs used for treating sinus tachycardia are limited to beta blockers, which restrict the effect of adrenaline on the sinus node. Other drugs used include calcium channel blockers and anti-arrhythmic drugs, which directly affect the firing rate of the sinus node.
• If the patient does not respond to drug therapy, a person can undergo radiofrequency catheter ablation or get a permanent pacemaker, after evaluating the safety and efficacy of the radiofrequency modification.
• If one experiences sinus tachycardia on feeling fear, it is important to calm down and rest. In most cases, resting will help in reducing palpitations and chest pain.
• Other treatment involves increasing salt intake, and in extreme cases, surgery is considered to treat sinus tachycardia.
• In some cases, it is best not to do anything to treat the condition.
• In other cases, the impaired sinus tachycardia improves over time, and if the condition is mild for someone, the situation gets better on its own.

The treatment varies based on the duration of the tachycardia and how well the patient is coping with the fast heart rate and reoccurrence after the rhythm returns to normal.

Reference

1. Randall J. Lee; Jonathan M. Kalman; Adam P. Fitzpatrick; Laurence M. Epstein; Westby G. Fisher; Jeffrey E. Olgin; Michael D. Lesh; Melvin M. Scheinman. Radiofrequency Catheter Modification of the Sinus Node for “Inappropriate” Sinus Tachycardia.