What is your first reflex when you are faced with sinus tachycardia?
Give fluids, make sure patient is not in overt shock. Most likely.
But what if your sinus tachycardia persists and the exact cause remains elusive? #thread
You see an 80ish y.o. admitted with failure to thrive and decreased oral intake. Found to have HR in the 110 bpm range. Previously ~80s. How to treat?
Medication list only included PPN and folic acid.
Dysautonomia plausible but no parkinsonism, no history of diabetes or neuropathy.
ncbi.nlm.nih.gov/pubmed/1959389
For the feeling of satisfaction such reasoning exercises bring, I'd do this again and again and again!
💓PE is a tricky diagnosis. Sometimes found incidentally. Rarely with full textbook picture. Expect to find it when unexpected. Expect not to find it when highly suspected.
💓Isolated persistent sinus tachycardia could be a sign of PE.
💓Thrombocytopenia can occur with large PE burden, improves with anticoagulation.
💓Super-high D-dimer levels almost always hide a VTE, cancer or sepsis. Investigate!
💓Do not beta block an unexplained sinus tachycardia and sleep on it. Could be deleterious.
💓If something doesn't perfectly make sense, think it and re-think it. You'll solve it.