Sick sinus syndrome pathophysiology: Difference between revisions

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[[Category:Needs content]]
[[Category:Needs content]]
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Amyloidosis]], [[atherosclerosis]], [[atrial septal defect]], [[cardiac surgery|cardiac surgery in children]], [[cardiomyopathies]], [[carotid sinus hypersensitivity]], [[congenital heart disease]], [[coronary artery disease]], [[Ebstein anomaly]], [[electrolyte imbalance]], [[hemochromatosis]], [[hyperkalemia]], [[hypertension]], [[hypocalcemia]], [[hypoxia]], [[ischemic heart disease]], [[Lyme disease]], [[myocardial infarction]], [[myocarditis]], [[neurocardiogenic syncope]], [[pericarditis]], [[rheumatic fever]], [[sinus node disease|sinus node fibrosis]], [[tachycardia-bradycardia syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Grayanotoxin]], [[rhododendron|rhododendron sp]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Lyme disease]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amiodarone]], [[antiarrhythmics]], [[beta blockers]], [[calcium channel blockers]], [[cimetidine]], [[clonidine]], [[digitalis]], [[disopyramide]], [[guanethidine]], [[lanatoside C]], [[lidocaine]], [[lithium]], [[methyldopa]], [[phenytoin]], [[procainamide]], [[propranolol]], [[quinidine]], [[reserpine]], [[verapamil]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Amyloidosis]], [[hemochromatosis]], [[hypocalcemia]], [[hypothyroidism]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Hemochromatosis]], [[sarcoidosis]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Friedreich ataxia]], [[HCN4|HCN4 mutation]], [[hemochromatosis]], [[muscular dystrophy]], [[myotonic dystrophy]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Hemochromatosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Chagas disease]], [[diphtheria]], [[Lyme disease]], [[pericarditis]], [[rheumatic fever]], [[sepsis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Friedreich ataxia]], [[hemochromatosis]], [[muscular dystrophy]], [[myotonic dystrophy]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Friedreich ataxia]], [[hypothermia]], [[muscular dystrophy]], [[myotonic dystrophy]], [[sleep apnea]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Amyloidosis]], [[electrolyte imbalance]], [[hyperkalemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Neoplasm]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| [[Hypertension]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Hypoxia]], [[sarcoidosis]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Electrolyte imbalance]], [[hyperkalemia]], [[hypertension]], [[hypocalcemia]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Amyloidosis]], [[rheumatic fever]], [[sarcoidosis]], [[scleroderma]], [[systemic lupus erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[cardiac surgery|Cardiac surgery in children]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Hypothermia]], [[idiopathic]]
|-
|}
===Causes in Alphabetical Order===
{{MultiCol}}
*[[Amiodarone]]
*[[Amyloidosis]]
*[[Antiarrhythmics]]
*[[Atherosclerosis]]
*[[Atrial septal defect]]
*[[Beta blockers]]
*[[Calcium channel blockers]]
*[[cardiac surgery|Cardiac surgery in children]]
*[[Cardiomyopathies]]
*[[Carotid sinus hypersensitivity]]
*[[Chagas disease]]
*[[Cimetidine]]
*[[Clonidine]]
*[[Congenital heart disease]]
*[[Coronary artery disease]]
*[[Digitalis]]
*[[Diphtheria]]
*[[Disopyramide]]
*[[Ebstein anomaly]]
*[[Electrolyte imbalance]]
*[[Friedreich ataxia]]
*[[Grayanotoxin]]
*[[Guanethidine]]
*[[HCN4|HCN4 mutation]]
*[[Hemochromatosis]]
*[[Hyperkalemia]]
*[[Hypertension]]
*[[Hypocalcemia]]
*[[Hypothermia]]
*[[Hypothyroidism]]
{{ColBreak}}
*[[Hypoxia]]
*[[Idiopathic]]
*[[Ischemic heart disease]]
*[[Lanatoside C]]
*[[Lidocaine]]
*[[Lithium]]
*[[Lyme disease]]
*[[Methyldopa]]
*[[Muscular dystrophy]]
*[[Myocardial infarction]]
*[[Myocarditis]]
*[[Myotonic dystrophy]]
*[[Neoplasm]]
*[[Neurocardiogenic syncope]]
*[[Pericarditis]]
*[[Phenytoin]]
*[[Procainamide]]
*[[Propranolol]]
*[[Quinidine]]
*[[Reserpine]]
*[[Rheumatic fever]]
*[[rhododendron|Rhododendron sp]]
*[[Sarcoidosis]]
*[[Scleroderma]]
*[[Sepsis]]
*[[sinus node disease|Sinus node fibrosis]]
*[[Sleep apnea]]
*[[Systemic lupus erythematosus]]
*[[Tachycardia-bradycardia syndrome]]
*[[Verapamil]]
{{EndMultiCol}}
==References==
{{Reflist|2}}
[[Category:Crowdiagnosis]]
[[Category:Electrophysiology]]
[[Category:Syndromes]]
[[Category:Cardiology]]
[[Category:Arrhythmia]]
[[Category:Up-To-Date]]
{{WH}}
{{WS}}

Revision as of 19:18, 28 September 2016

Sick sinus syndrome revolves around an improperly propagated signal from the sinoatrial(SA) node. Some of the causes for this propagation abnormality include degenerative fibrosis of the SA node, abnormalities in ion-channel conduction, and and a remodeling of the node itself. As a disease of the elderly, it is most commonly thought to be secondary to the age-related idiopathic fibrosis of the nodal tissue.[1] Studies on familial and congenital presentations of sick sinus syndrome have also revealed genetic contributions to dysfunctional ion channels.[2] Recent research has revealed a higher incidence of SSS in carriers of a rare variant of the MYH6 gene, which encodes the alpha heavy chain subunit of cardiac myosin, further delineating a possible genetic basis to the disease. [3]

In some patients, heart failure and atrial fibrillation can also be causes of remodeling of the SA node leading to increased sinus node recovery time, abnormal propagation of the action potential from the node and changes in nodal sensitivity. [4] [5] Hemochromatosis, sarcoidosis, amyloidosis and other infiltrative disease process may contribute to intrinsic dysfunction of the sinoatrial node, [1] as can chronic ischemia secondary to atherosclerotic changes of arteries supplying the SA node.[6]

References

  1. ↑ 1.0 1.1 Semelka M, Gera J, Usman S (2013). "Sick sinus syndrome: a review". Am Fam Physician. 87 (10): 691–6. PMID 23939447.
  2. ↑ Benson DW, Wang DW, Dyment M, Knilans TK, Fish FA, Strieper MJ; et al. (2003). "Congenital sick sinus syndrome caused by recessive mutations in the cardiac sodium channel gene (SCN5A)". J Clin Invest. 112 (7): 1019–28. doi:10.1172/JCI18062. PMC 198523. PMID 14523039.
  3. ↑ Holm H, Gudbjartsson DF, Sulem P, Masson G, Helgadottir HT, Zanon C; et al. (2011). "A rare variant in MYH6 is associated with high risk of sick sinus syndrome". Nat Genet. 43 (4): 316–20. doi:10.1038/ng.781. PMC 3066272. PMID 21378987.
  4. ↑ Elvan A, Wylie K, Zipes DP (1996). "Pacing-induced chronic atrial fibrillation impairs sinus node function in dogs. Electrophysiological remodeling". Circulation. 94 (11): 2953–60. PMID 8941126.
  5. ↑ Dobrzynski H, Boyett MR, Anderson RH (2007). "New insights into pacemaker activity: promoting understanding of sick sinus syndrome". Circulation. 115 (14): 1921–32. doi:10.1161/CIRCULATIONAHA.106.616011. PMID 17420362.
  6. ↑ Alboni P, Baggioni GF, Scarfò S, Cappato R, Percoco GF, Paparella N; et al. (1991). "Role of sinus node artery disease in sick sinus syndrome in inferior wall acute myocardial infarction". Am J Cardiol. 67 (15): 1180–4. PMID 2035437.
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