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Updated: August 31, 2025
The patient almost invariably must sit up, or at least have his head raised. The auricles of the heart may act more energetically than normal, and precede as usual the ventricular contraction; or the auricles and ventricles may contract almost together a so-called "nodal" type of contraction. Rarely does a patient die of paroxysmal tachycardia.
The presence of a well marked case of exophthalmic goiter is not necessary for the secretion of the thyroid to be increased sufficiently to cause tachycardia; in fact, an increased heart rapidity in women often has hyperthyroidism as its cause.
It is different from paroxysmal tachycardia, in which the heart rate rarely exceeds 180 per minute. In auricular flutter there is always present a certain amount of heart block, not all the stimuli reaching the ventricle. There may be a ratio of auricular contractions to ventricular contractions, according to Fulton, of 2:1, 3:1, 4:1 and 5:1, the 2:1 ratio being most common.
A permanently rapid heart, when the patient has no heart lesion and is at rest, is generally due to hypersecretion of the thyroid, which will be discussed later. Paroxysmal tachycardia is a name applied to very rapid heart attacks in persons who are more or less subject to their recurrence.
If none of these symptoms is present, though a patient has received digitalis for broken compensation, a tachycardia occurring might not contraindicate digitalis, as much of the digitalis on the market is useless; and a patient may not actually have been obtaining digitalis action.
The treatment of an actual degeneration of the heart from overuse of alcohol is similar to the sane condition from other causes. Caffein can irritate the heart and cause irregularity and tachycardia, especially in certain persons.
Kisch has described, as a cardiac neurosis of sexual origin, a pathological tachycardia which is an exaggeration of the physiological quick heart of sexual excitement.
If the tachycardia occurs in a patient with arteriosclerosis, especially if there is much cardiac pain, nitroglycerin is of advantage; also warm foot-baths. If there is prostration and a flaccid, flabby abdomen, a tight abdominal bandage may be of benefit. Gastric flatulence, while perhaps not a cause of the tachycardia, is liable to develop and be a troublesome symptom.
Its satisfactory action is to increase the cardiac activity, slightly lower the blood pressure, and increase the peripheral circulation and the health of the skin. If it causes tachycardia, nervous excitement, sleeplessness or loss of weight, it is doing harm and the dose is too large, or it is not indicated.
He found also that if a state of perfect rest could be obtained during the waking period, the pulse rate was slowed. This is also true in cases of compensated cardiac lesions, but it was not true in decompensated hearts. He found that irregularities such as extrasystoles and organic tachycardia did not disappear during sleep, whereas functional tachycardia did.
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