Sinus Tachycardia

• Etiology/Risk Factors
  • Catecholamines
    • Stress
    • Pain
    • Medications
      • Norepinephrine reuptake blockers
      • Recreational drugs
  • Hypovolemia
  • Endocrine abnormalities
  • Metabolic derangements
  • Anemia
  • Hypoxia

• Pathophysiology
  • Heart rate greater than 100 beats/min (Figure 6.11)
    • Can precipitate angina by increasing myocardial oxygen demand
• Treatment
  • Generally no long‐term treatment unless symptomatic
  • Stress management exercises
  • Treat underlying cause
  • β‐blockers
• Primary Concerns
  • ↑ CO and stress on the heart
  • The underlying cause contributing to the tachycardia
• Evaluation
  • Consider cardiology consult
  • Consider preoperative ECG
  • Consider BMP
  • Establish underlying source of preoperative tachycardia
• Anesthesia Management
  • Anxiety
    • Behavioral
    • Sedative‐hypnotics
  • Pain
    • Analgesics
    • Local anesthetics
  • Hypovolemia
    • Fluids
  • If ischemia develops, consider β‐blockers if MAP is adequate
    • MI treatment covered on page 254

Atrial Fibrillation

• Etiology/Risk Factors
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