Sinus bradycardia causes

	Sinus bradycardia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]

Overview

Sinus bradycardia does not necessarily refer to the presence of an obvious pathology; in fact, it may occur in normal, healthy individuals including well-trained athletes, some elderly people or during sleep. It may also be due to an exaggerated response to normal physiological processes (e.g. vomiting, coughing, defecation) or from pathologies involving the SA node such as sick sinus syndrome, myocardial infarction. The most common medications causing sinus bradycardia are beta blockers, digitalis and calcium channel blockers. However, life-threatening conditions including chemical poisoning (organophosphate, sarin), sepsis, electrolyte imbalance should be promptly recognized and treated.

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

Causes by Organ System

Cardiovascular	Carotid sinus hypersensitivity, endocarditis, hypertrophic cardiomyopathy, left ventricular noncompaction, LQT4 mutation, myocardial infarction, myocarditis, pericarditis, sick sinus syndrome, vasovagal syncope
Chemical/Poisoning	Carbamate poisoning, lily of the valley poisoning, nerve agent, organophosphates
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Adenosine, alfentanil, ambenonium, amiodarone, atenolol, bethanechol, bupivacaine, calcium channel blocker, celecoxib, cilobradine,^[1] citalopram, clonidine, deserpidine, diltiazem, dimethyl sulfoxide, distigmine, dronedarone, febuxostat, fentanyl,fingolimod, flecainide, fosphenytoin, grayanotoxin, guanethidine, H2 receptor antagonist, ivabradine, lanreotide, lidocaine, lofexidine, mefloquine, methyldopa, mexiletine, muscarine, nadolol, nefazodone,neostigmine, paclitaxel, palonosetron, physostigmine, procainamide, propranolol, quinidine, rabeprazole, regadenoson, reserpine, sedative, somatostatin, sotalol, sufentanil,suxamethonium, toluene sniffing, topical cocaine, verapamil, veratridine (false hellebore), zaleplon, zatebradine ^[2]
Ear Nose Throat	No underlying causes
Endocrine	Cretinism, diabetic neuropathy, hemochromatosis, hypothyroidism, tumor lysis syndrome
Environmental	Altitude sickness, decompression sickness, electric shock, hypothermia
Gastroenterologic	No underlying causes
Genetic	Arnold-Chiari malformation, cretinism, HCN4 mutation, hemochromatosis, LQT4 mutation, myotonic dystrophy , SCN5A mutation
Hematologic	Hemochromatosis
Iatrogenic	Cardiac catheterization, cardiac transplantation, toluene sniffing, transcatheter aortic valve implantation
Infectious Disease	Babesiosis, brucellosis, Chagas disease, dengue fever, diptheria, legionellosis, leptospirosis , Lyme disease, malaria, meningitis , Q fever , rabies, rheumatic fever, rocky mountain spotted fever, sepsis , trichinosis, typhoid fever, typhus, viral hemorrhagic fever, yellow fever
Musculoskeletal/Orthopedic	Myotonic dystrophy
Neurologic	Cerebral edema, diabetic neuropathy, epilepsy, increased intracranial pressure, meningitis, rabies, subarachnoid hemorrhage, vasovagal syncope
Nutritional/Metabolic	Hypoglycemia, kwashiorkor, sepsis
Obstetric/Gynecologic	Pregnancy
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	Crizotinib toxicity, digitalis toxicity, fluoxetine, fluvoxamine, ibutilide toxicity, lithium toxicity
Psychiatric	Anorexia nervosa
Pulmonary	Cough syncope, drowning, hypercapnia, obstructive sleep apnea, sarcoidosis
Renal/Electrolyte	Hypercalcemia, hyperkalemia, hypermagnesemia, hypokalemia
Rheumatology/Immunology/Allergy	Amyloidosis, neonatal lupus erythematosus, rheumatoid arthritis, sarcoidosis, scleroderma, systemic lupus erythematosus
Sexual	No underlying causes
Trauma	Cervical spine injury
Urologic	No underlying causes
Miscellaneous	Aging, altitude sickness, decompression sickness, defecation, drowning, micturition syncope, nausea, sleep, starvation, trained athletes, valsalva maneuver, vomiting

Causes in Alphabetical Order

References

↑ van bogaert, pp.; pittoors, f. (2003). "use-dependent blockade of cardiac pacemaker current (if) by cilobradine and zatebradine". eur j pharmacol. 478 (2–3): 161–71. PMID 14575801. Unknown parameter |month= ignored (help)
↑ ^2.0 ^2.1 ^2.2 Van Bogaert, PP.; Pittoors, F. (2003). "Use-dependent blockade of cardiac pacemaker current (If) by cilobradine and zatebradine". Eur J Pharmacol. 478 (2–3): 161–71. PMID 14575801. Unknown parameter |month= ignored (help)

Template:WikiDoc Sources

[van_bogaert-2003-1] van bogaert, pp.; pittoors, f. (2003). "use-dependent blockade of cardiac pacemaker current (if) by cilobradine and zatebradine". eur j pharmacol. 478 (2–3): 161–71. PMID 14575801. Unknown parameter |month= ignored (help)

[Van_Bogaert-2003-2] 2.0 ^2.1 ^2.2 Van Bogaert, PP.; Pittoors, F. (2003). "Use-dependent blockade of cardiac pacemaker current (If) by cilobradine and zatebradine". Eur J Pharmacol. 478 (2–3): 161–71. PMID 14575801. Unknown parameter |month= ignored (help)

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