Sinus tachycardia
Cough and Breathlessness in a Young Adult
A 20-year-old woman presents with a productive cough, breathlessness, and chest pain.
Look for
- Sinus P-wave activity before the QRS complexes.
- Adult heart rate above 100/min.
Where to look. Look for P waves in II and aVF, then compare aVR. Count QRS complexes over a known duration.
The sinus node speeds up while maintaining the P–QRS sequence. The ECG identifies the rhythm; it cannot by itself prove infection or another cause.
COVID-19 infection and pulmonary emboli were documented during evaluation; several factors may accelerate the rhythm.
References & provenance
The ECG Made Easy, 9e, ch. 4, PDF 91–93; Lilly, 6e, ch. 12, p. 293.
COVID-19 Infection and Acute Pulmonary Embolism in an Adolescent Female With Sickle Cell Disease
Sushma Kasinathan; Hasina Mohammad Ashraf; Sheera Minkowitz; Adebayo Adeyinka; Keneisha Bailey-Correa; Alexander Muacevic; John R Adler. COVID-19 Infection and Acute Pulmonary Embolism in an Adolescent Female With Sickle Cell Disease. 2020. doi:10.7759/cureus.12348. Figure 2. CC BY 4.0. CC BY 4.0
Adaptation: cropping and removal of headers/annotations outside the tracing where applicable; metadata removed. Waveforms have not been redrawn.
Compared with the published source; no independent clinical validation is claimed.
Original annotations & limitations
Tachycardie sinusale dans un contexte infectieux
Femme de 20 ans; toux productive, dyspnée et douleur thoracique; infection COVID-19, embolies pulmonaires et drépanocytose diagnostiquées lors du bilan.
L’infection est authentique; l’embolie et l’hypoxémie peuvent aussi contribuer à la tachycardie. Ne pas enseigner une cause unique.