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Sick sinus syndrome
Alternative namesSick sinus syndrome is a group of abnormal heartbeats (arrhythmias) presumably caused by a malfunction of the sinus node, the heart's "natural" pacemaker.
Causes, incidence, and risk factors
Sick sinus syndrome is a relatively uncommon syndrome. It can result in many abnormal heart rhthyms (arrhythmias), including sinus arrest, sinus node exit block, sinus bradycardia, and other other types of bradycardia (slow heart rate).
Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as PSVT and atrial fibrillation . Tachycardias that occur with sick sinus syndrome are characterized by a long pause after the tachycardia.
Abnormal rhythms are often caused or worsened by medications such as digitalis, calcium channel blockers, beta-blockers, 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 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.
Signs and tests
The symptoms are non-specific and may mimic other disorders. The patient's heart rate may be very slow at any time or after termination of an episode of tachycardia. Blood pressure may be normal or low.
If the disorder is without symptoms, no treatment is necessary. Medications that worsen symptoms should be stopped.
A permanent implanted pacemaker may be necessary when it has been established that the symptoms are related to bradycardia (slow heart rate).
Any associated tachycardia (a fast heart rate) may be treated with medications after the person is protected from symptomatic bradycardia by a pacemaker.
Expectations (prognosis)This syndrome is slowly progressive. As long as the person remains without symptoms, no treatment is necessary. If a permanent pacemaker is needed, the long-term outlook is excellent.
Calling your health care providerCall for an appointment with your health care provider if you experience light-headed spells, episodes of passing out, palpitations, or other symptoms.
PreventionTreatment of related disorders may be helpful. Many times, the condition is not preventable.
Update Date: 2/10/2003Thippeswamy H. Murthy, M.D., Division of Cardiology, Washington Hospital Center, Washington, DC. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT