From the Guidelines
Tachycardia can be concerning and requires evaluation to determine its underlying cause, as it may signal severe underlying pathologies, according to the most recent guidelines 1.
Definition and Causes
Tachycardia is defined as a heart rate greater than 100 beats per minute, and it can result from various physiological and pathological causes, including fever, anemia, hypotension, heart failure, hyperthyroidism, and exogenous substances such as caffeine and illicit stimulant drugs 1.
Evaluation and Management
The management of tachycardia involves identifying and treating the underlying cause, rather than the tachycardia itself 1.
- For healthy individuals, a mildly elevated heart rate may return to normal once temporary factors resolve.
- However, if tachycardia persists at rest without obvious causes or is accompanied by symptoms such as chest pain, dizziness, shortness of breath, or unusual fatigue, medical evaluation is necessary.
- Certain populations, including pregnant women, athletes, and individuals with heart conditions, may require different interpretations of their heart rate.
Monitoring and Documentation
If concerned about a consistently elevated heart rate, monitoring it over several days at different times and documenting any associated symptoms can provide valuable information for healthcare providers to determine if further evaluation is necessary 1. In summary, while tachycardia can be a normal response to various stimuli, it is essential to evaluate its underlying cause to determine the appropriate course of action, prioritizing morbidity, mortality, and quality of life as outcomes 1.
From the Research
Tachycardia Concerns
- Tachycardia can be a symptom of various conditions, including heart failure, which is a common, progressive, complex clinical syndrome with high morbidity and mortality 2.
- The evaluation of symptomatic patients with suspected heart failure, including those with tachycardia, is directed at confirming the diagnosis, determining the cause, identifying concomitant illnesses, establishing the severity of heart failure, and guiding therapy 2.
- In patients with sudden cardiac arrest, tachycardia can be a consequence of the event, and electrical remodeling of the ECG can occur due to prolongation of ventricular depolarization (QRSD), which may assist with prognostication 3.
- The History, Electrocardiogram, Age, Risk Factors, Troponin (HEART) score is a prospectively validated risk stratification tool for patients presenting to the emergency department with chest pain, and tachycardia can be a factor in this score 4.
- In the diagnosis of acute heart failure in the emergency department, tachycardia can be a symptom, and ED assessments may include electrocardiogram, which can help diagnose heart failure 5.
Diagnostic Considerations
- Physical examination findings, including those related to tachycardia, are often not sensitive or specific for heart failure, and other conditions may mimic radiograph findings 5.
- Point-of-care ultrasound can facilitate the diagnosis of heart failure by assessing for B-lines, cardiac function, and inferior vena cava size, which can be useful in patients with tachycardia 5.
- Clinical observations based on a combination of history, physical examination, laboratory values, and clinician experience remain the best approach to diagnosing conditions related to tachycardia, such as dehydration 6.