Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, OH (K.A.M.).
Karolinska Institutet & Karolinska University Hospital, Stockholm, Sweden (A.F.).
Circ Arrhythm Electrophysiol. 2022 Sep;15(9):e007960. doi: 10.1161/CIRCEP.121.007960. Epub 2022 Sep 8.
Sinus tachycardia (ST) is ubiquitous, but its presence outside of normal physiological triggers in otherwise healthy individuals remains a commonly encountered phenomenon in medical practice. In many cases, ST can be readily explained by a current medical condition that precipitates an increase in the sinus rate, but ST at rest without physiological triggers may also represent a spectrum of normal. In other cases, ST may not have an easily explainable cause but may represent serious underlying pathology and can be associated with intolerable symptoms. The classification of ST, consideration of possible etiologies, as well as the decisions of when and how to intervene can be difficult. ST can be classified as secondary to a specific, usually treatable, medical condition (eg, pulmonary embolism, anemia, infection, or hyperthyroidism) or be related to several incompletely defined conditions (eg, inappropriate ST, postural tachycardia syndrome, mast cell disorder, or post-COVID syndrome). While cardiologists and cardiac electrophysiologists often evaluate patients with symptoms associated with persistent or paroxysmal ST, an optimal approach remains uncertain. Due to the many possible conditions associated with ST, and an overlap in medical specialists who see these patients, the inclusion of experts in different fields is essential for a more comprehensive understanding. This article is unique in that it was composed by international experts in Neurology, Psychology, Autonomic Medicine, Allergy and Immunology, Exercise Physiology, Pulmonology and Critical Care Medicine, Endocrinology, Cardiology, and Cardiac Electrophysiology in the hope that it will facilitate a more complete understanding and thereby result in the better care of patients with ST.
窦性心动过速(sinus tachycardia,简称 ST)非常常见,但在其他健康个体中,除了正常生理触发因素之外,窦性心动过速仍然是医学实践中常见的现象。在许多情况下,窦性心动过速可以通过当前的诱发窦性频率增加的医疗状况来解释,但在没有生理触发因素的情况下静息时出现的窦性心动过速也可能代表正常的一种频谱。在其他情况下,窦性心动过速可能没有易于解释的原因,但可能代表严重的潜在病理学,并可能与无法忍受的症状相关。窦性心动过速的分类、可能病因的考虑,以及何时以及如何干预的决策可能很困难。窦性心动过速可分为继发于特定的、通常可治疗的医疗状况(例如,肺栓塞、贫血、感染或甲状腺功能亢进)或与几种未完全定义的状况相关(例如,不适当的窦性心动过速、体位性心动过速综合征、肥大细胞疾病或新冠后综合征)。虽然心脏病专家和心脏电生理学家经常评估与持续性或阵发性窦性心动过速相关的症状的患者,但仍不确定最佳方法。由于与窦性心动过速相关的许多可能状况,以及看到这些患者的医学专家的重叠,因此纳入不同领域的专家对于更全面的理解至关重要。本文的独特之处在于,它由神经病学、心理学、自主医学、过敏和免疫学、运动生理学、肺病和危重病医学、内分泌学、心脏病学和心脏电生理学方面的国际专家共同撰写,希望这将有助于更全面地理解,并因此为窦性心动过速患者提供更好的护理。