Sick sinus syndrome: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
===Causes=== | ===Causes=== | ||
*Intrinsic: | |||
**degenerative fibrosis | |||
**infiltrative disease process | |||
**ion channel dysfunction | |||
**SA node remodeling | |||
*Extrinsic: | |||
**pharmacologic | |||
**metabolic/electrolyte disturbance | |||
**autonomic, OSA | |||
==Workup== | ==Workup== | ||
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==Management== | ==Management== | ||
*remove extrinsic factors and/or pacemakers | |||
**Pacemakers do not reduce mortality, only decrease symptoms | |||
==Disposition== | ==Disposition== | ||
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===Complications=== | ===Complications=== | ||
*(50%) Tachy-brady syndrome with atrial fibrillation or atrial flutter | |||
*(50%) AV block | |||
==See Also== | ==See Also== | ||
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==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Cards]] | [[Category:Cards]] | ||
Revision as of 01:20, 7 June 2015
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
References
- ↑ 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