Sinus bradycardia: Difference between revisions
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== Differential Diagnosis of Causes of Sinus Bradycardia== | == Differential Diagnosis of Causes of Sinus Bradycardia== | ||
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | ||
Atenolol | |||
Bethanechol | |||
Bupivacaine | |||
Cervical spine injury | |||
Cilobradine | |||
Deserpidine | |||
Diltiazem | |||
Distigmine | |||
Fentanyl | |||
Foetal distress | |||
Hypermagnesaemia | |||
Ivabradine | |||
Kwashiorkor | |||
Lofexidine | |||
Miller-Dieker syndrome | |||
Neostigmine | |||
Organophosphates | |||
* [[Ambenonium]] | |||
* [[Acetylcholine]] | * [[Acetylcholine]] | ||
* [[Alfentanil]] | * [[Alfentanil]] | ||
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* [[Digitalis]] | * [[Digitalis]] | ||
* [[Dimethyl sulfoxide]] ([[DMSO]]) | * [[Dimethyl sulfoxide]] ([[DMSO]]) | ||
* [[Diptheria]] | |||
* Drugs | * Drugs | ||
* [[Electrocution]] | |||
* [[Fentanyl]] | * [[Fentanyl]] | ||
* [[Hypercalcemia]] | * [[Hypercalcemia]] | ||
* [[Hypercapnia]] | * [[Hypercapnia]] | ||
* [[Hyperkalemia]] | * [[Hyperkalemia]] | ||
* [[Hyoglycemia]] | |||
* [[Hypothermia]] | * [[Hypothermia]] | ||
* [[Hypothyroidism]] | * [[Hypothyroidism]] | ||
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* [[Lithium]] | * [[Lithium]] | ||
* [[Meningitis]] | * [[Meningitis]] | ||
* [[STEMI|Myocardial Infarction]] | * [[STEMI|Myocardial Infarction]], particularly inferior MI | ||
* [[Myocarditis]] | * [[Myocarditis]] | ||
* [[Paclitaxel]] | * [[Paclitaxel]] | ||
* Physical training, elite athlete | * Physical training, elite athlete statu | ||
* [[Propranolol]] | |||
* [[Quinidine]] | * [[Quinidine]] | ||
* [[Reserpine]] | * [[Reserpine]] | ||
* [[Rheumatic fever]] | |||
* [[Sepsis]] | * [[Sepsis]] | ||
* [[Sick Sinus Syndrome]] ([[SSS]]) | * [[Sick Sinus Syndrome]] ([[SSS]]) | ||
* [[Sleep apnea]] | |||
* [[Sotalol]} | |||
* [[Spinal cord injury]] | |||
* [[Sufentanil]] | * [[Sufentanil]] | ||
* [[Suxamethonium]] | |||
* Tight fitting neckwear | * Tight fitting neckwear | ||
* [[Toluene]] | * [[Toluene]] | ||
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* [[Vagal nerve]] stimulation | * [[Vagal nerve]] stimulation | ||
* [[Vagotonia]] | * [[Vagotonia]] | ||
* [[Valsalva maneuver]] | |||
* [[Vasovagal syncope]] | * [[Vasovagal syncope]] | ||
* [[Verapamil]] | |||
* [[Yellow fever]] | |||
* [[Zatebradine]] | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 01:20, 23 February 2011
| Sinus bradycardia | |
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| Sinus bradycardia. | |
| ICD-9 | 427.81 |
| eMedicine | emerg/ |
| MeSH | D001146 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Sinus bradycardia is a heart rhythm that originates from the sinus node and has a rate of under 60 beats per minute. Common causes include sick sinus syndrome and pharmacotherapy such as beta-blockers. Sinus bradycardia is not unexpected in highly trained athletes. It only requires treatment if the patient is symptomatic.
Pathosphysiology
This rhythm may be caused by one of the following:
- Increased vagal tone.
- Intrinsic disease of the SA node.
- An effect of drugs, such as the use of digitalis, beta-blockers, or quinidine.
- Sleep
- It is a normal finding in a healthy, well-conditioned athlete.
Differential Diagnosis of Causes of Sinus Bradycardia
In alphabetical order. [1] [2] Atenolol Bethanechol Bupivacaine Cervical spine injury Cilobradine Deserpidine Diltiazem Distigmine Fentanyl Foetal distress Hypermagnesaemia Ivabradine Kwashiorkor Lofexidine Miller-Dieker syndrome Neostigmine Organophosphates
- Ambenonium
- Acetylcholine
- Alfentanil
- Amiodarone
- Amyloidosis
- Beta blocker
- Brucellosis
- Calcium channel blocker
- Carotid sinus hypersensitivity
- Cardiac catheterization
- Clonidine
- Congenital Heart Disease
- Digitalis
- Dimethyl sulfoxide (DMSO)
- Diptheria
- Drugs
- Electrocution
- Fentanyl
- Hypercalcemia
- Hypercapnia
- Hyperkalemia
- Hyoglycemia
- Hypothermia
- Hypothyroidism
- Hypoxia
- Increased intracranial pressure
- Lithium
- Meningitis
- Myocardial Infarction, particularly inferior MI
- Myocarditis
- Paclitaxel
- Physical training, elite athlete statu
- Propranolol
- Quinidine
- Reserpine
- Rheumatic fever
- Sepsis
- Sick Sinus Syndrome (SSS)
- Sleep apnea
- [[Sotalol]}
- Spinal cord injury
- Sufentanil
- Suxamethonium
- Tight fitting neckwear
- Toluene
- Tumors of the neck
- Tumor lysis syndrome
- Typhoid Fever
- Vagal nerve stimulation
- Vagotonia
- Valsalva maneuver
- Vasovagal syncope
- Verapamil
- Yellow fever
- Zatebradine
Diagnosis
Symptoms
The decreased heart rate can cause a decreased cardiac output resulting in symptoms such as lightheadedness, dizziness, hypotension, vertigo, and syncope.
Sinus bradycardia may lead to no symptoms in a young athlete.
ECG Characteristics
- Rate: Less than 60.
- Rhythm: Regular.
- P waves: Upright, consistent, and normal in morphology and duration.
- PR Interval: Between 0.12-0.20 seconds in duration.
- QRS complex: Less than 0.12 seconds in width, and consistent in morphology.
Treatment
Asymptomatic sinus bradycardia requires no treatment.
References
See also
Additional resources
- ECGpedia: Course for interpretation of ECG
- The whole ECG - A basic ECG primer
- 12-lead ECG library
- Simulation tool to demonstrate and study the relation between the electric activity of the heart and the ECG
- ECG information from Children's Hospital Heart Center, Seattle
- ECG Challenge from the ACC D2B Initiative
- National Heart, Lung, and Blood Institute, Diseases and Conditions Index
- A history of electrocardiography
- EKG Interpretations in infants and children
EKG Examples
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Sinus bradycardia -
Sinus bradycardia
