Sick sinus syndrome: Difference between revisions
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==Background== | ==Background== | ||
*Collection of bradyarrhythmias with or without tachycardia<ref>Semelka, M et Al. Sick Sinus Syndrome: A Review. Am Fam Physician. 2013 May 15;87(10):691-696. http://www.aafp.org/afp/2013/0515/p691.html</ref> | |||
*50% have alternating bradycardia and tachycardia | |||
==Clinical Features== | ==Clinical Features== | ||
*Clinical manifestations related to end-organ hypoperfusion | |||
**Syncope/pre-syncope (50%) | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Workup== | ==Workup== | ||
*ECG identification, inpatient telemetry, outpatient Holter monitoring, event monitoring, loop monitoring | |||
**ECG frequently negative for findings early in disease course | |||
==Management== | ==Management== | ||
Revision as of 06:34, 24 August 2014
Background
- Collection of bradyarrhythmias with or without tachycardia[1]
- 50% have alternating bradycardia and tachycardia
Clinical Features
- Clinical manifestations related to end-organ hypoperfusion
- Syncope/pre-syncope (50%)
Differential Diagnosis
Causes
- Intrinsic:
- degenerative fibrosis
- infiltrative disease process
- ion channel dysfunction
- SA node remodeling
- Extrinsic:
- pharmacologic
- metabolic/electrolyte disturbance
- autonomic, OSA
Workup
- ECG identification, inpatient telemetry, outpatient Holter monitoring, event monitoring, loop monitoring
- ECG frequently negative for findings early in disease course
Management
- remove extrinsic factors and/or pacemakers
- Pacemakers do not reduce mortality, only decrease symptoms
Disposition
Admit
Complications
- (50%) Tachy-brady syndrome with atrial fibrillation or atrial flutter
- (50%) AV block
See Also
External Links
Sources
- ↑ Semelka, M et Al. Sick Sinus Syndrome: A Review. Am Fam Physician. 2013 May 15;87(10):691-696. http://www.aafp.org/afp/2013/0515/p691.html