Sinus tach... what do y'all think?

Specialties Cardiac

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Ok, I'm going to make it short but informative.

I am 25 y/o female, student nurse, no previous history of cardiac problems. My history includes malignant melanoma and asthma. I am on no asthma meds except my rescue inhaler (albuterol) and haven't used it for over 2 months.

Last night I was in the ER for sinus tachycardia, rate oscillating between 150-180 (went as high as 192 at one point). Was given Inderal, Adenosine, and Ativan (not in that order). Had ekg done, normal ekg with sinus tach and ST elevation. Of course I'm supposed to follow up with a cardiologist for a holter monitor, echocardiogram, and stress test.

Any insight into this? I'm not on any stimulants (had a soda for breakfast yesterday, this didn't start til about 7 pm), I'm under stress but not unusual amounts of stress.... what does the ST elevation indicate? I'd appreciate any info.

Thanks!,

Rebecca

(who is extremely tired today.... I felt like I ran a bazillion marathons yesterday)

Originally posted by delirium

Ok, I'm going to make it short but informative.

I am 25 y/o female, student nurse, no previous history of cardiac problems. My history includes malignant melanoma and asthma. I am on no asthma meds except my rescue inhaler (albuterol) and haven't used it for over 2 months.

Last night I was in the ER for sinus tachycardia, rate oscillating between 150-180 (went as high as 192 at one point). Was given Inderal, Adenosine, and Ativan (not in that order). Had ekg done, normal ekg with sinus tach and ST elevation. Of course I'm supposed to follow up with a cardiologist for a holter monitor, echocardiogram, and stress test.

Any insight into this? I'm not on any stimulants (had a soda for breakfast yesterday, this didn't start til about 7 pm), I'm under stress but not unusual amounts of stress.... what does the ST elevation indicate? I'd appreciate any info.

Thanks!,

Rebecca

(who is extremely tired today.... I felt like I ran a bazillion marathons yesterday)

ST elevation is indicative of ischemia at the very least. If it was an MI, the preliminary reading of the EKG would have suggested it. Are you sure it was sinus tach and not a rapid atrial fib? That's usually what adenosine is for. Do you smoke? Drink a lot of caffeinated beverages? What's your family history of heart disease? Definitely see a cardiologist ASAP. You also need lab work done to check your electrolyte levels especially your potassium and magnesium levels. Did they do cardiac enzymes when you were in the ER? They should have at least kept you as an observation patient. There are so many reasons why this happened that don't have to be caused by your heart. The rapid rate could be a side effect of another issue. You could be dehydrated or anemic and your body is making demands for blood that isn't there. Keep the appointment and keep us posted. Be Blessed. Renay

No answers, Rebecca, but hope you are doing better!

Specializes in Cath Lab/ ICU.

Tough to see ST elevation at a rate of 180. And if it's over 160 it's tough to see the p wave as well, meaning it's SVT not ST.

ST always has an underlying reason: pain, fever, etc

SVT, meh,not so much.

I get SVT every now and then for no reason, my spouse gets it all the time. Haven't found a reason for it yet either. It's been years...

Pericarditis can present with tachycardia and diffuse ST elevation. Have you recently had a cold or URI ? Glad you are being checked out. You need at least an echocardiogram!

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

As this thread is nine years old :eek: I doubt member is around to view responses. :)

Also, per the Terms of Service we may not give medical advice.

Thanks to all for taking the time to post.

Closing the thread now.

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