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> | ||
* [[Ambenonium]] | * [[Ambenonium]] | ||
* [[Acetylcholine]] | * [[Acetylcholine]] | ||
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* [[Amiodarone]] | * [[Amiodarone]] | ||
* [[Amyloidosis]] | * [[Amyloidosis]] | ||
* [[Atenolol]] | |||
* [[Ativan]] | |||
* [[Beta blocker]] | * [[Beta blocker]] | ||
* [[Bethanechol]] | |||
* [[Brucellosis]] | * [[Brucellosis]] | ||
* [[Bupivacaine]] | |||
* [[Calcium channel blocker]] | * [[Calcium channel blocker]] | ||
* [[Carotid sinus hypersensitivity]] | * [[Carotid sinus hypersensitivity]] | ||
* Cardiac catheterization | * Cardiac catheterization | ||
* [[Cervical spine injury]] | |||
* [[Cilobradine]] | |||
* [[Clonidine]] | * [[Clonidine]] | ||
* [[Congenital Heart Disease]] | * [[Congenital Heart Disease]] | ||
* [[Deserpidine]] | |||
* [[Digitalis]] | * [[Digitalis]] | ||
* [[Diltiazim]] | |||
* [[Dimethyl sulfoxide]] ([[DMSO]]) | * [[Dimethyl sulfoxide]] ([[DMSO]]) | ||
* [[Diptheria]] | * [[Diptheria]] | ||
* [[Distigmine]] | |||
* Drugs | * Drugs | ||
* [[Electrocution]] | * [[Electrocution]] | ||
* [[Fentanyl]] | * [[Fentanyl]] | ||
* [[Fetal distress]] | |||
* [[Hypercalcemia]] | * [[Hypercalcemia]] | ||
* [[Hypercapnia]] | * [[Hypercapnia]] | ||
* [[Hyperkalemia]] | * [[Hyperkalemia]] | ||
* [[Hypermagnesemia]] | |||
* [[Hyoglycemia]] | * [[Hyoglycemia]] | ||
* [[Hypothermia]] | * [[Hypothermia]] | ||
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* [[Hypoxia]] | * [[Hypoxia]] | ||
* [[Increased intracranial pressure]] | * [[Increased intracranial pressure]] | ||
* [[Ivabradine]] | |||
* [[Kwashiorkor]] | |||
* [[Lidocaine]] | |||
* [[Lithium]] | * [[Lithium]] | ||
* [[Lofexidine]] | |||
* [[Meningitis]] | * [[Meningitis]] | ||
* [[Miller-Dieker syndrome]] | |||
* [[STEMI|Myocardial Infarction]], particularly inferior MI | * [[STEMI|Myocardial Infarction]], particularly inferior MI | ||
* [[Myocarditis]] | * [[Myocarditis]] | ||
* [[Neostigmine]] | |||
* [[Organophosphates]] | |||
* [[Paclitaxel]] | * [[Paclitaxel]] | ||
* Physical training, elite athlete statu | * Physical training, elite athlete statu | ||
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* [[Vasovagal syncope]] | * [[Vasovagal syncope]] | ||
* [[Verapamil]] | * [[Verapamil]] | ||
* [[Vicodin]] | |||
* [[Yellow fever]] | * [[Yellow fever]] | ||
* [[Zatebradine]] | * [[Zatebradine]] | ||
Revision as of 01:49, 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 or beta-blockers.
- Sleep
- Sinus bradycardia is a normal finding in a healthy, well-conditioned athlete.
Differential Diagnosis of Causes of Sinus Bradycardia
In alphabetical order. [1] [2]
- Ambenonium
- Acetylcholine
- Alfentanil
- Amiodarone
- Amyloidosis
- Atenolol
- Ativan
- Beta blocker
- Bethanechol
- Brucellosis
- Bupivacaine
- Calcium channel blocker
- Carotid sinus hypersensitivity
- Cardiac catheterization
- Cervical spine injury
- Cilobradine
- Clonidine
- Congenital Heart Disease
- Deserpidine
- Digitalis
- Diltiazim
- Dimethyl sulfoxide (DMSO)
- Diptheria
- Distigmine
- Drugs
- Electrocution
- Fentanyl
- Fetal distress
- Hypercalcemia
- Hypercapnia
- Hyperkalemia
- Hypermagnesemia
- Hyoglycemia
- Hypothermia
- Hypothyroidism
- Hypoxia
- Increased intracranial pressure
- Ivabradine
- Kwashiorkor
- Lidocaine
- Lithium
- Lofexidine
- Meningitis
- Miller-Dieker syndrome
- Myocardial Infarction, particularly inferior MI
- Myocarditis
- Neostigmine
- Organophosphates
- 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
- Vicodin
- 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
