Sinus Tachycardia

Sinus Tachycardia

Sinus tachycardia is a resting heart rate greater than 100 beats per minute. The decisive factor here is that the excitation comes from the main clock generator, the sinus node in the right atrium, and the electrical signal follows the normal conduction system of the heart. A distinction is made between the primary form, in which there are no recognizable organic causes, and the secondary form of sinus tachycardia, which can often be explained by a compensatory reaction of the heart to an underlying disease.

What is sinus tachycardia?

Sinus tachycardia is an arrhythmia of the heart in which the electrical sequence of the beating rhythm from excitation in the sinus node and transmission to the ventricles via the AV node corresponds to the heart’s normal conduction system. A heart rate greater than one hundred beats per minute at rest is classified as sinus tachycardia. For median paralysis definitions, please visit

This does not apply to a physiologically caused rapid heart rhythm, because the heart rate can increase to more than one hundred beats per minute when there is a corresponding demand for performance and in babies and small children without there being a pathological sinus tachycardia. A distinction is made between primary and secondary sinus tachycardia. A primary form of tachycardia is when there are no organic or exogenous causes of the high heart rate.

The secondary form is usually based on a compensatory increase in heart rate due to certain target parameters such as insufficient oxygen saturation or anemia. The rapid heart rhythm can also be caused by a hormonal imbalance or as an undesirable side effect of medication. For example, hyperthyroidism, an overactive thyroid gland, can cause sinus tachycardia.


By definition, the causes of primary sinus tachycardia are unknowable, but those of the secondary form of the disease are. Factors that can cause the rapid heart rhythm outside of the rate increases considered physiological are very complex and lie within the heart itself or are abnormalities or diseases outside of the heart.

In many cases, it is a compensatory reaction of the heart to compensate for a resulting or emerging undersupply of oxygen and nutrients. Typical causes of this category are lack of oxygen (hypoxia), anemia (anemia) and abnormally low blood pressure ( hypotension ), which can be caused by a lack of fluids (dehydration), for example. Febrile illnesses can be classified as conditionally compensatory or conditionally physiological.

For every one degree Celsius increase in body temperature, the heart rate increases by around ten beats per minute. This is probably a precautionary measure taken by the body to prevent an imminent lack of oxygen. Metabolic processes are exorbitantly accelerated with an increase in body temperature.

Typical causes of sinus tachycardia that cannot be explained by compensatory processes are hyperthyroidism (hyperthyroidism) and reactions to drugs (sympathomimetics), stimulants or drugs (caffeine, ecstasy). Other triggers of a pathological heart rate increase can be based in the heart itself. These are usually illnesses such as cardiac insufficiency, myocardial infarction or inflammation of the myocardium.

Symptoms, Ailments & Signs

Primary or secondary sinus tachycardia initially causes few specific symptoms. This is especially true if your heart rate is constantly increasing. A temporary tachycardia is usually accompanied by noticeable palpitations and a high pulse.

Intermittent and sudden tachycardias often have specific triggers such as stress, fear or physical demands. A permanent sinus tachycardia does not necessarily make itself felt through perceptible heart palpitations, but rather through general exhaustion and a reduction in performance under stress. The heart rate remains unnaturally high even when you are resting.

Diagnosis & course of disease

The most important tools for differentiating sinus tachycardia from other cardiac arrhythmias such as the common atrial fibrillation are electrocardiograms (ECG) and echocardiograms, which are performed externally or as transesophageal ultrasound (TEE). In TEE, the ultrasound machine is inserted into the esophagus (gullet) while the patient is lightly sedated.

The ultrasound examination of the beating heart provides valuable data on the volume of the atria and ventricles as well as on the wall thickness of the myocardium and information on the functionality of the individual heart valves. The ECG pattern also allows conclusions to be drawn about cardiovascular diseases that may be present. Both diagnostics complement each other perfectly and also cover part of the necessary differential diagnostics.


In the worst case, the sinus tachycardia can lead to heart failure and thus to the death of the person concerned. However, this only occurs if the disease is not treated. Those affected suffer from a very high pulse and also palpitations. There is an inner restlessness and the patients can also break out in a sweat or have panic attacks.

Symptoms such as anxiety or stress also occur, which have a negative impact on the quality of life of those affected. Sinus tachycardia can also occur during physical exertion. In many cases, the patients suffer from tiredness and exhaustion, with the pulse being significantly increased even when at rest.

The treatment of sinus tachycardia usually depends on the underlying disease. In many cases, drugs are used to reduce the heart rate. There are no complications. In acute emergencies, however, treatment by an emergency doctor is required to avoid the death of the patient. Unfortunately, it cannot be universally predicted whether the patient’s life expectancy will be reduced due to the illness.

When should you go to the doctor?

Sinus tachycardia is completely normal in many cases, such as with rapid movement or excitement. However, if it occurs more frequently or if the patient cannot explain its occurrence, it is advisable to go to the doctor. He can determine whether it is actually the physiological sinus tachycardia or whether another clinical picture is present. The right contacts for this diagnosis are the family doctor, the internist or the cardiologist. In many cases, several visits to the doctor are necessary because the ideal diagnosis requires that the occurrence of the sinus tachycardia be recorded on the ECG and thus be clearly assessed.

Even after the diagnosis of sinus tachycardia, it can be important to see a doctor. This applies to cases in which the occurrence of the cardiac acceleration changes in nature. New symptoms such as dizziness or even fainting make it urgently necessary to see a doctor. The same applies to cases in which the patient is very frightened by the actual racing heart. Here the risk of cardiac neurosis is to be feared, in which the patient escalates into harmless symptoms and the quality of life can drop significantly. The one-time clarification of heart health is helpful, but also a discussion with the psychologist, who can also consider individual behavioral therapy.

Treatment & Therapy

The first goal of treating sinus tachycardia is to determine the cause. If the cause of the rapid heartbeat is known, the complex of causes is primarily treated so that the rapid rhythm recedes on its own if the cause is successfully eliminated or healed. There is primary sinus tachycardia for which no specific cause could be diagnosed.

Treatment consists primarily of symptomatic medication with beta-blockers. They occupy the so-called beta-receptors so that the stress hormones adrenaline and noradrenaline cannot dock and thus cannot become effective. Blocking the beta-receptors in the heart lowers blood pressure and slows the heart rate.

In the kidneys, stress hormones even develop a kind of leverage effect, because after adrenaline and noradrenaline dock, hormones such as angiotensin are released, which have a vasoconstrictive effect and cause an increase in blood pressure and heart rate. As in the heart, the beta receptors in the kidneys are also inactivated by beta blockers, so that the stress hormones cannot become effective.


The best preventive measures to prevent sinus tachycardia are to avoid risks that can provoke cardiovascular disease. Above all, careful handling of caffeine, nicotine and alcohol is recommended. Equally important is a balanced diet that also includes natural foods. Even a minimum amount of exercise can be classified in the category of preventive measures.


As a rule, those affected by sinus tachycardia have only limited and only a few direct aftercare measures available, so that those affected by this disease should consult a doctor as early as possible. The sooner a doctor is consulted, the better the further course of this disease. Therefore, the patient should initiate treatment as soon as the first symptoms and signs appear.

Sinus tachycardia cannot heal on its own. In most cases, patients are dependent on taking various medications to properly and permanently relieve the symptoms. If anything is unclear or you have questions, you should always consult a doctor first so that complications do not arise later on.

In general, stress should also be avoided, whereby the person concerned should rest and take it easy. Likewise, in the case of sinus tachycardia, a healthy lifestyle with a balanced diet can have a positive effect on the further course of this disease, whereby obesity should also be avoided. The disease can also reduce the life expectancy of those affected in some cases.

You can do that yourself

In many cases, sinus tachycardia is physiological and does not require treatment. However, if it disturbs or even frightens the person concerned, there are ways of self-help with which the phenomenon can often be well controlled. The prerequisite for this is that the accelerated heartbeat has been clarified beforehand by a cardiologist or at least by a family doctor. This is not only for the safety of the patient, but also for their reassurance, which is often very important for coping with the psychological aspect of the sinus tachycardia.

The psychological component in particular is very important when the heart is racing. If those affected think that they have heart disease, the fear increases the tachycardia and a vicious circle can develop. It is therefore very important that those affected keep in mind after the medical clarification that an accelerated heartbeat during sex, excitement and sport is completely normal. If this does not succeed, psychological support is often advisable so that no cardiac neurosis can develop.

In everyday life, an acceleration of the heartbeat can definitely be reduced or even avoided. The consumption of nicotine, alcohol and coffee is an essential factor for cardiac acceleration and should therefore be limited as much as possible. Heart palpitations after a sumptuous meal are also possible. This is called Roemheld syndrome. This can be avoided if patients eat smaller portions, especially before bedtime.

Sinus Tachycardia