sick sinus syndrome

definition
1. a group of heart rhythm problems (arrhythmias) in which the sinus node doesn't work properly.
sinus node
1. specialized cells which have the ability to spontaneously produce action potential.
signs and symptoms
1. dizziness
2. angina
3. abnormal pulse
  1. rate
    1. tachycardia
    2. bradycardia
  2. rhythm
    1. Regularly irregularly
      1. Second degree atrioventricular block • Sinus arrhythmia
    2. Irregularly irregular
      1. Atrial Fibrillation Multiple ectopics
    3. Occasionally irregular
      1. Extrasystole
  3. volume
    1. High
      1. physiological: Exercise\ Pregnancy Advanced Age
      2. pathological: Arteriosclerosis \ Aortic regurgitation\ Arteriovenous fistula
    2. Low
      1.  LeftVentricular Failure\  Hypovolemia\  Peripheral arterial disease
    3.  Varying
      1. Atrial fibrillation\ VentricularTachycardia
  4. character
    1. Slow rising 
      1. severe aortic stenosis
    2. Anacrotic
      1. Aortic Stenosis
    3. Dicrotic
      1. Cardiac Tamponade
4. fainting & fatigue
5. Unconsciousness
  1. nervous causes
    1. Traumatic brain injury
    2. Brain hypoxia
    3. Poisoning
    4. Anaesthesia
  2. pulmonary causes
    1. asthma
    2. Respiratory arrest
  3. metabolic causes
    1. Hyper/hypoglycaemia
    2. hepatic failure
    3. hypopituitarism
    4. Myxoedema
  4. cardiac causes
    1. Electrical problems
    2. ventricular fibrillation
    3. cardiac arrest
    4. coronary artery disease
    5. heart attack
    6. congenital heart disease
idiopathic cause (degeneration&fibrosis of SA-N)
diagnosis
1. ECG (findings)
  1. Inappropriate sinus bradycardia
  2. Sinus arrest
  3. Sinoatrial block
  4. Atrial fibrillation
  5. Tachy-Brady Syndrome
2. Electrophysiologic testing
  1. check the function of the sinus node
Treatment
1. anti-arrhythmic drugs
  1. Amiodarone
    1. Vasodilator and cardiac depressant. Prolong AP duration.
    2. ADRS: Cardiac: heart block, hypotension, bradycardia, pneumonitis.
CPR
1. Airway
  1. clear the airway
2. compression
  1. restore blood circulation
3. Breathing
  1. provide breathe for the person
conduction system
Arrhythmia
1. tachy-arrhythmia
  1. abnormally fast rhythms (Heart rate > 100 beat/min).
2. brady-arrhythmia
  1. abnormally slow rhythms (heart rate < 60 beat/min)
management
1. pacemaker
  1. Dual-chamber pacemaker
  2. Biventricular pacemaker
  3. Single-chamber pacemaker
2. implantable cardioverter defibrillator
  1. It is a battery-powered device that is placed under the skin which keeps tracking the heart rate.

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sick sinus syndrome

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	Created by Fatima K over 7 years ago