Sinus tachycardia differential diagnosis

Differentiating Sinus Tachycardia from other Disorders

Usually apparent on the EKG, but if heart rate is above 140 bpm the P wave may be difficult to distinguish from the previous T waveand one may confuse it with a paroxysmal supraventricular tachycardia or atrial flutter with a 2:1 block. Ways to distinguish the three are:

• Vagal maneuvers (such as carotid sinus massage or Valsalva maneuver) to slow the rate and identification of P waves
• Administer AV blockers (e.g., adenosine, verapamil) to identify atrial flutter with 2:1 block

Postural orthostatic tachycardia syndrome (POTS)

Postural orthostatic tachycardia syndrome (POTS) usually occurs in women with no known heart problems. This syndrome is characterized by normal resting heart rate but exaggerated postural sinus tachycardia with or without orthostatic hypotension.