Key Points about inappropriate sinus tachycardia 

  • Inappropriate sinus tachycardia (IST) is characterized by an abnormally fast heart rate (over 100 bpm) without a clear cause. 
  • The condition can cause symptoms like palpitations, dizziness and shortness of breath, especially with normal activities. 
  • IST is often triggered by autonomic nervous system dysfunction or hormonal imbalances, like hyperthyroidism. 
  • Diagnosis involves an ECG, Holter monitor and blood tests to rule out other causes. 
  • Treatment may include medications like beta-blockers, stress management and in some cases, catheter ablation.
Common related conditions
Heart (Cardiovascular) Disease Atrial Tachycardia Bradycardia Arrhythmia

Inappropriate sinus tachycardia causes 

Inappropriate sinus tachycardia may be caused by: 

  • Overactivity of the sinus node (the heart’s natural pacemaker). 
  • Dysfunction in the autonomic nervous system, which controls the heart rate. 
  • Hormonal imbalances, such as those found in hyperthyroidism. 
  • Chronic stress or anxiety, which can exacerbate symptoms. 
  • Certain medications or stimulants that elevate the heart rate. 

Inappropriate sinus tachycardia risk factors 

Risk factors for IST include: 

  • Female gender, as the condition is more common in women, particularly young adults. 
  • A history of stress, anxiety, or panic disorders. 
  • Thyroid conditions, particularly hyperthyroidism. 
  • A family history of arrhythmias or related heart conditions.
  • Use of stimulant medications or recreational drugs. 

Inappropriate sinus tachycardia symptoms 

Common symptoms of IST include: 

  • A consistently high heart rate, typically over 100 beats per minute, even when at rest. 
  • Palpitations or the feeling of your heart racing. 
  • Dizziness or lightheadedness, especially with physical activity. 
  • Shortness of breath, fatigue, or reduced exercise tolerance. 
  • Chest discomfort or tightness in some cases. 

Inappropriate sinus tachycardia diagnosis 

To diagnose IST, doctors will often use: 

  • An electrocardiogram (ECG or EKG) to detect an elevated heart rate and rule out other arrhythmias. 
  • A Holter monitor to track the heart's activity over a 24-hour period and capture episodes of tachycardia. 
  • Blood tests to check for thyroid issues or other potential contributing factors. 
  • Sometimes autonomic function testing to evaluate the nervous system's role in heart rate regulation. 

Inappropriate sinus tachycardia treatment 

Treatment for IST can include: 

  • Medications like beta-blockers or calcium channel blockers to help control heart rate. 
  • Treatment of underlying conditions, such as hyperthyroidism, if applicable. 
  • Stress reduction techniques, such as relaxation exercises, yoga, or meditation. 
  • In severe cases, catheter ablation may be considered to modify the activity of the sinus node. 

When to Seek Care 

Seek medical care if you experience: 

  • A persistently fast heart rate, especially if it's causing palpitations, dizziness, or shortness of breath. 
  • New or worsening symptoms that interfere with daily activities. 
  • Any discomfort or chest pain associated with a rapid heart rate. 
  • Difficulty exercising or increased fatigue that you haven't experienced before. 

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