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{{Sick sinus syndrome}}
{{Sick sinus syndrome}}
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==Overview==
==Overview==
Sick sinus syndrome can result in many abnormal heart rhythms ([[arrhythmias]]), including [[sinus arrest]], [[sinus node exit block]], [[sinus bradycardia]], and other types of [[bradycardia]] (slow heart rate).  Sick sinus syndrome may also be caused by a variety of [[conditions]] including but not limited to [[myocardial infarction]], [[atrial fibrillation]], [[drugs]] or toxins, [[infections]],[[medications]], [[electrolyte abnormalities]], [[hypothermia]], [[hypoxemia]], [[hypercarbia]], and [[acidosis]].
==Causes==
==Causes==
Sick sinus syndrome can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, [[sinus bradycardia]], and other types of [[bradycardia]] (slow heart rate).
===Life Threatening Causes===
 
Life-threatening causes include [[conditions]] which may result in death or permanent disability within 24 hours if left untreated.
Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as [[paroxysmal supraventricular tachycardia ]] (PSVT) and atrial fibrillation. Tachycardias that occur with sick sinus syndrome are characterized by a long pause after the tachycardia.
*[[Myocardial infarction]]
 
*[[Myocarditis]]
Abnormal rhythms are often caused or worsened by medications such as [[digitalis]], [[calcium channel blocker]]s, [[beta-blocker]]s, sympatholytic medications, and anti-arrhythmics. Disorders that cause scarring, degeneration, or damage to the conduction system can cause sick sinus syndrome, including [[sarcoidosis]], [[amyloidosis]], [[Chagas' disease]], and cardiomyopathies.
 
Sick sinus syndrome is more common in elderly adults, where the cause is often a non-specific, scar-like degeneration of the [[Electrical conduction system of the heart|cardiac conduction system]]. Cardiac surgery, especially to the [[atria]], is a common cause of sick sinus syndrome in children.
 
[[Coronary artery disease]], high blood pressure, and aortic and mitral valve diseases may be associated with sick sinus syndrome, although this association may only be incidental.
 
===Life Threatening Causese===
 
===Common Causes===
===Common Causes===
Common [[causes]] of sick sinus syndrome include:<ref name="pmid6406388">{{cite journal |vauthors=Weintraub M, Hes JP, Rotmensch HH, Soferman G, Liron M |title=Extreme sinus bradycardia associated with lithium therapy |journal=Isr. J. Med. Sci. |volume=19 |issue=4 |pages=353–5 |date=April 1983 |pmid=6406388 |doi= |url=}}</ref><ref name="pmid7018848">{{cite journal |vauthors=Thormann J, Neuss H, Schlepper M, Mitrovic V |title=Effects of clonidine on sinus node function in man |journal=Chest |volume=80 |issue=2 |pages=201–6 |date=August 1981 |pmid=7018848 |doi=10.1378/chest.80.2.201 |url=}}</ref><ref name="pmid15949188">{{cite journal |vauthors=Puljiz I, Beus A, Kuzman I, Seiwerth S |title=Electrocardiographic changes and myocarditis in trichinellosis: a retrospective study of 154 patients |journal=Ann Trop Med Parasitol |volume=99 |issue=4 |pages=403–11 |date=June 2005 |pmid=15949188 |doi=10.1179/136485905X36307 |url=}}</ref><ref name="pmid17570992">{{cite journal |vauthors=Assimakopoulos SF, Michalopoulou S, Papakonstantinou C, Lekkou A, Syrokosta I, Gogos C |title=A case of severe sinus bradycardia complicating anicteric leptospirosis |journal=Am. J. Med. Sci. |volume=333 |issue=6 |pages=381–3 |date=June 2007 |pmid=17570992 |doi=10.1097/MAJ.0b013e3180659578 |url=}}</ref><ref name="pmid15761461">{{cite journal |vauthors=Cunha BA, Thermidor M, Mohan S, Valsamis AS, Johnson DH |title=Fever of unknown origin: subacute thyroiditis versus typhoid fever |journal=Heart Lung |volume=34 |issue=2 |pages=147–51 |date=2005 |pmid=15761461 |doi=10.1016/j.hrtlng.2004.07.003 |url=}}</ref><ref name="pmid11284920">{{cite journal |vauthors=Cunha BA |title=The diagnostic significance of relative bradycardia in infectious disease |journal=Clin. Microbiol. Infect. |volume=6 |issue=12 |pages=633–4 |date=December 2000 |pmid=11284920 |doi=10.1046/j.1469-0691.2000.0194f.x |url=}}</ref><ref name="pmid23939447">{{cite journal| author=Semelka M, Gera J, Usman S| title=Sick sinus syndrome: a review. | journal=Am Fam Physician | year= 2013 | volume= 87 | issue= 10 | pages= 691-6 | pmid=23939447 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23939447  }} </ref><ref name="RubensteinSchulman1972">{{cite journal|last1=Rubenstein|first1=Joel J.|last2=Schulman|first2=Charles L.|last3=Yurchak|first3=Peter M.|last4=Desanctis|first4=Roman W.|title=Clinical Spectrum of the Sick Sinus Syndrome|journal=Circulation|volume=46|issue=1|year=1972|pages=5–13|issn=0009-7322|doi=10.1161/01.CIR.46.1.5}}</ref>


===Causes in Alphabetical Order===
*[[Atrial fibrillation]]
*Athletic training
*[[Drugs]] or toxins, including:
**[[Toluene]]
**[[Organophosphates]]
**[[Tetrodotoxin]]
**[[Cocaine]]
*[[Infections]]:
**[[Lyme disease]]
**[[Legionella]]
**[[Psittacosis]]
**[[Typhoid fever]]
**[[Typhus]]
**[[Listeria]]
**[[Malaria]]
**[[Leptospirosis]]
**[[Dengue fever]]
**viral hemorrhagic fevers
**[[Guillain-Barre]]
*[[Medications]]:
**[[Beta blockers]]
**[[Calcium channel blockers]]
**[[Digoxin]]
**[[Sympatholytic medications]]
**[[Antiarrhythmic medications]]
**[[Lithium]]
*[[Cardiac surgery]]
*Electrolyte abnormalities
*[[Hypothermia]]
*[[Hypoxemia]], hypercarbia, [[acidosis]]
*[[Coronary artery disease]]


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
[[Category:Crowdiagnosis]]
[[Category:Electrophysiology]]
[[Category:Syndromes]]
[[Category:Cardiology]]
[[Category:Arrhythmia]]
[[Category:Up-To-Date]]
 
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{{WH}}
{{WS}}
{{WS}}

Latest revision as of 23:21, 29 March 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ogheneochuko Ajari, MB.BS, MS [3]

Overview

Sick sinus syndrome can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia (slow heart rate). Sick sinus syndrome may also be caused by a variety of conditions including but not limited to myocardial infarction, atrial fibrillation, drugs or toxins, infections,medications, electrolyte abnormalities, hypothermia, hypoxemia, hypercarbia, and acidosis.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Common causes of sick sinus syndrome include:[1][2][3][4][5][6][7][8]

References

  1. Weintraub M, Hes JP, Rotmensch HH, Soferman G, Liron M (April 1983). "Extreme sinus bradycardia associated with lithium therapy". Isr. J. Med. Sci. 19 (4): 353–5. PMID 6406388.
  2. Thormann J, Neuss H, Schlepper M, Mitrovic V (August 1981). "Effects of clonidine on sinus node function in man". Chest. 80 (2): 201–6. doi:10.1378/chest.80.2.201. PMID 7018848.
  3. Puljiz I, Beus A, Kuzman I, Seiwerth S (June 2005). "Electrocardiographic changes and myocarditis in trichinellosis: a retrospective study of 154 patients". Ann Trop Med Parasitol. 99 (4): 403–11. doi:10.1179/136485905X36307. PMID 15949188.
  4. Assimakopoulos SF, Michalopoulou S, Papakonstantinou C, Lekkou A, Syrokosta I, Gogos C (June 2007). "A case of severe sinus bradycardia complicating anicteric leptospirosis". Am. J. Med. Sci. 333 (6): 381–3. doi:10.1097/MAJ.0b013e3180659578. PMID 17570992.
  5. Cunha BA, Thermidor M, Mohan S, Valsamis AS, Johnson DH (2005). "Fever of unknown origin: subacute thyroiditis versus typhoid fever". Heart Lung. 34 (2): 147–51. doi:10.1016/j.hrtlng.2004.07.003. PMID 15761461.
  6. Cunha BA (December 2000). "The diagnostic significance of relative bradycardia in infectious disease". Clin. Microbiol. Infect. 6 (12): 633–4. doi:10.1046/j.1469-0691.2000.0194f.x. PMID 11284920.
  7. Semelka M, Gera J, Usman S (2013). "Sick sinus syndrome: a review". Am Fam Physician. 87 (10): 691–6. PMID 23939447.
  8. Rubenstein, Joel J.; Schulman, Charles L.; Yurchak, Peter M.; Desanctis, Roman W. (1972). "Clinical Spectrum of the Sick Sinus Syndrome". Circulation. 46 (1): 5–13. doi:10.1161/01.CIR.46.1.5. ISSN 0009-7322.

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