__NOTOC__
{{Sick sinus syndrome}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How to Edit a Page|here]] to learn about editing.

{{CMG}}
==Epidemiology and Demographics==
===Age and Gender===
Sick sinus syndrome usually occurs in people older than 50. It is uncommon in children, but if present, it is usually secondary to trauma to the atrium during cardiac surgery. <ref name="pmid25104520">{{cite journal| author=Ewy GA| title=Sick sinus syndrome: synopsis. | journal=J Am Coll Cardiol | year= 2014 | volume= 64 | issue= 6 | pages= 539-40 | pmid=25104520 | doi=10.1016/j.jacc.2014.05.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25104520 }} </ref>

The incidence of SSS increases with increasing age, however no difference in incidence was seen between men and women.<ref name="pmid17420362">{{cite journal| author=Dobrzynski H, Boyett MR, Anderson RH| title=New insights into pacemaker activity: promoting understanding of sick sinus syndrome. | journal=Circulation | year= 2007 | volume= 115 | issue= 14 | pages= 1921-32 | pmid=17420362 | doi=10.1161/CIRCULATIONAHA.106.616011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17420362 }} </ref> The number of SSS cases in the United States is expected to more than double over the next 50 years. <ref name="pmid25104519">{{cite journal| author=Jensen PN, Gronroos NN, Chen LY, Folsom AR, deFilippi C, Heckbert SR et al.| title=Incidence of and risk factors for sick sinus syndrome in the general population. | journal=J Am Coll Cardiol | year= 2014 | volume= 64 | issue= 6 | pages= 531-8 | pmid=25104519 | doi=10.1016/j.jacc.2014.03.056 | pmc=4139053 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25104519 }} </ref>

== References ==
{{Reflist|2}}

[[Category:Needs content]]

Sick sinus syndrome epidemiology and demographics

2016-10-21T00:40:58Z

Anis Kadado: /* Overview */

2016-09-29T18:01:43Z

Anis Kadado:

Sick sinus syndrome pathophysiology

2016-09-29T18:00:21Z

Anis Kadado:

Sick sinus syndrome pathophysiology

2016-09-28T19:18:38Z

Anis Kadado:

Sick sinus syndrome pathophysiology

2016-09-28T19:18:21Z

2016-09-28T18:40:25Z

Anis Kadado:

Sick sinus syndrome pathophysiology

2016-09-28T18:26:37Z

Anis Kadado:

__NOTOC__

{{Sick sinus syndrome}}

j
== References ==
{{Reflist|2}}

[[Category:Needs content]]

Sick sinus syndrome medical therapy

2016-09-26T03:05:24Z

Anis Kadado: /* Medical Therapy */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==Medical Therapy==
Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy. However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.

In patients with bradyarrhythmias, there are no medications that can increase the heart rate and therefore will require pacemaker implantation. This will alleviate heart rates that are too slow or prolonged pauses in patients with SSS. In patients with bradycardia-tachycardia syndrome, pacemaker implantation with medications to slow the heart rate may be required. Persons suffering from SSS may have other conditions increasing their risk of stroke, such as atrial fibrillation, and should thus be treated with anticoagulants. <ref name="pmid14623796">{{cite journal| author=Gregoratos G| title=Cardiology patient pages. Sick sinus syndrome. | journal=Circulation | year= 2003 | volume= 108 | issue= 20 | pages= e143-4 | pmid=14623796 | doi=10.1161/01.CIR.0000102938.55119.EC | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14623796 }} </ref>

===Contraindicated medications===
{{MedCondContrAbs

|MedCond = Sick sinus syndrome|Adenosine|Carvedilol|Diltiazem|Dronedarone|Esmolol|Fingolimod|Metoprolol|Nebivolol|Propafenone|Verapamil}}

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome physical examination

2016-09-26T02:43:56Z

Anis Kadado: /* Physical Examination */

__NOTOC__
{{Sick sinus syndrome}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{CMG}}
==Overview==
==Physical Examination==

Besides bradycardia or the presence of an arrhythmia, physical findings in patients with SSS are uncommonly pertinent in establishing the diagnosis. <ref name="pmid185894">{{cite journal| author=Scarpa WJ| title=The sick sinus syndrome. | journal=Am Heart J | year= 1976 | volume= 92 | issue= 5 | pages= 648-60 | pmid=185894 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=185894 }} </ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome physical examination

2016-09-26T02:42:59Z

Anis Kadado: /* Physical Examination */

Sick sinus syndrome history and symptoms

2016-09-26T02:21:38Z

Anis Kadado: /* Symptoms */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==History==
Diagnosing SSS can often be challenging due to nonspecific symptoms and inconsistent findings on electrocardiogram or Holter monitor. Patients may be asymptomatic and the finding incidental or present with symptoms related to decreased cardiac output. 50 percent of patients present with syncope or pre-syncope related to the decreased cerebral perfusion secondary to bradyarrhythmias or tachyarrhythmias. <ref name="pmid12725451">{{cite journal| author=Adán V, Crown LA| title=Diagnosis and treatment of sick sinus syndrome. | journal=Am Fam Physician | year= 2003 | volume= 67 | issue= 8 | pages= 1725-32 | pmid=12725451 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12725451 }} </ref>

==Symptoms==
Patients with mild SSS may be asymptomatic and unaware of any underlying illness. Other patients with symptomatic SSS may experience brief symptoms or more severe manifestations. Some of the symptoms that may develop among patients include: <ref name="pmid14623796">{{cite journal| author=Gregoratos G| title=Cardiology patient pages. Sick sinus syndrome. | journal=Circulation | year= 2003 | volume= 108 | issue= 20 | pages= e143-4 | pmid=14623796 | doi=10.1161/01.CIR.0000102938.55119.EC | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14623796 }} </ref>

* [[Dizziness]] or light-headedness
* [[Palpitations]]
* [[Chest pain]] or [[Angina pectoris|angina]]
* [[Shortness of breath]]
* [[Fatigue]]
* [[Headache]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome history and symptoms

2016-09-26T02:20:30Z

Anis Kadado: /* History and Symptoms */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==History==
Diagnosing SSS can often be challenging due to nonspecific symptoms and inconsistent findings on electrocardiogram or Holter monitor. Patients may be asymptomatic and the finding incidental or present with symptoms related to decreased cardiac output. 50 percent of patients present with syncope or pre-syncope related to the decreased cerebral perfusion secondary to bradyarrhythmias or tachyarrhythmias. <ref name="pmid12725451">{{cite journal| author=Adán V, Crown LA| title=Diagnosis and treatment of sick sinus syndrome. | journal=Am Fam Physician | year= 2003 | volume= 67 | issue= 8 | pages= 1725-32 | pmid=12725451 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12725451 }} </ref>

==Symptoms==
Even though many types of sick sinus syndrome produce no symptoms, patients may present with:
* [[Stokes-Adams attack]]s - fainting due to [[asystole]] or [[ventricular fibrillation]]
* [[Dizziness]] or light-headedness
* [[Palpitations]]
* [[Chest pain]] or [[Angina pectoris|angina]]
* [[Shortness of breath]]
* [[Fatigue]]
* [[Headache]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome history and symptoms

2016-09-26T02:19:35Z

Anis Kadado: /* History and Symptoms */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==History and Symptoms==
Diagnosing SSS can often be challenging due to nonspecific symptoms and inconsistent findings on electrocardiogram or Holter monitor. Patients may be asymptomatic and the finding incidental or present with symptoms related to decreased cardiac output. 50 percent of patients present with syncope or pre-syncope related to the decreased cerebral perfusion secondary to bradyarrhythmias or tachyarrhythmias. <ref name="pmid12725451">{{cite journal| author=Adán V, Crown LA| title=Diagnosis and treatment of sick sinus syndrome. | journal=Am Fam Physician | year= 2003 | volume= 67 | issue= 8 | pages= 1725-32 | pmid=12725451 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12725451 }} </ref>

Patients with mild SSS may be asymptomatic and unaware of any underlying illness. Other patients with symptomatic SSS may experience brief symptoms or more severe manifestations. Some of the symptoms that may develop among patients include: palpitations, fainting, dizziness, fatigue, weakness, confusion, and angina. <ref name="pmid14623796">{{cite journal| author=Gregoratos G| title=Cardiology patient pages. Sick sinus syndrome. | journal=Circulation | year= 2003 | volume= 108 | issue= 20 | pages= e143-4 | pmid=14623796 | doi=10.1161/01.CIR.0000102938.55119.EC | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14623796 }} </ref>

==Symptoms==
Even though many types of sick sinus syndrome produce no symptoms, patients may present with:
* [[Stokes-Adams attack]]s - fainting due to [[asystole]] or [[ventricular fibrillation]]
* [[Dizziness]] or light-headedness
* [[Palpitations]]
* [[Chest pain]] or [[Angina pectoris|angina]]
* [[Shortness of breath]]
* [[Fatigue]]
* [[Headache]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome natural history, complications and prognosis

2016-09-26T02:00:57Z

Anis Kadado: /* Prognosis */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==Natural History, Complications and Prognosis==

===Natural History===
Brief, but gradually worsening cardiac rhythm abnormalities typically ensue as part of the natural history of SSS. These disorders have been associated with higher rates of cardiovascular events and increased mortality rates. With time, the rhythm disturbances tend to evolve, along with higher rates of thromboembolic events. <ref name="pmid913143">{{cite journal| author=Lien WP, Lee YS, Chang FZ, Lee SY, Chen CM, Tsai HC| title=The sick sinus syndrome: natural history of dysfunction of the sinoatrial node. | journal=Chest | year= 1977 | volume= 72 | issue= 5 | pages= 628-34 | pmid=913143 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=913143 }} </ref>

===Complications===
* [[Angina]]
* Decreased exercised capacity
* [[Fainting]] ([[syncope]])
* Falls or injury caused by fainting
* [[Heart failure]]
* Poor heart pumping
===Prognosis===
* The syndrome is progressive, which means it usually gets worse over time.

* The long-term outlook is excellent for people who have a [[permanent pacemaker]] implanted.

The long-term progression of SSS is mostly related to the presence and severity of associated coronary or hypertensive cardiac disease. <ref name="pmid2403955">{{cite journal| author=Rodriguez RD, Schocken DD| title=Update on sick sinus syndrome, a cardiac disorder of aging. | journal=Geriatrics | year= 1990 | volume= 45 | issue= 1 | pages= 26-30, 33-6 | pmid=2403955 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2403955 }} </ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome natural history, complications and prognosis

2016-09-26T02:00:33Z

Anis Kadado: /* Prognosis */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==Natural History, Complications and Prognosis==

===Natural History===
Brief, but gradually worsening cardiac rhythm abnormalities typically ensue as part of the natural history of SSS. These disorders have been associated with higher rates of cardiovascular events and increased mortality rates. With time, the rhythm disturbances tend to evolve, along with higher rates of thromboembolic events. <ref name="pmid913143">{{cite journal| author=Lien WP, Lee YS, Chang FZ, Lee SY, Chen CM, Tsai HC| title=The sick sinus syndrome: natural history of dysfunction of the sinoatrial node. | journal=Chest | year= 1977 | volume= 72 | issue= 5 | pages= 628-34 | pmid=913143 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=913143 }} </ref>

===Complications===
* [[Angina]]
* Decreased exercised capacity
* [[Fainting]] ([[syncope]])
* Falls or injury caused by fainting
* [[Heart failure]]
* Poor heart pumping
===Prognosis===
* The syndrome is progressive, which means it usually gets worse over time.

* The long-term outlook is excellent for people who have a [[permanent pacemaker]] implanted.

The long-term progression of SSS is mostly related to the presence and severity of coronary or hypertensive cardiac disease. <ref name="pmid2403955">{{cite journal| author=Rodriguez RD, Schocken DD| title=Update on sick sinus syndrome, a cardiac disorder of aging. | journal=Geriatrics | year= 1990 | volume= 45 | issue= 1 | pages= 26-30, 33-6 | pmid=2403955 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2403955 }} </ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome history and symptoms

2016-09-26T01:58:34Z

Anis Kadado: /* History and Symptoms */

__NOTOC__
{{Sick sinus syndrome}}
{{CMG}}
==Overview==
==History and Symptoms==
Diagnosing SSS can often be challenging due to nonspecific symptoms and inconsistent findings on electrocardiogram or Holter monitor. Patients may be asymptomatic and the finding incidental or present with symptoms related to decreased cardiac output. 50 percent of patients present with syncope or pre-syncope related to the decreased cerebral perfusion secondary to bradyarrhythmias or tachyarrhythmias.

Symptoms may have been present for months or years and can range be asymptomatic or mildly symptomatic which include palpitations, fatigue, confusion, and even syncope and sudden death.

Peripheral thromboembolism and stroke, which can occur in the presence of bradycardia-tachycardia syndrome (alternating bradyarrhythmias and tachyarrhythmias), may be related to dysrhythmia-induced emboli. <ref name="pmid3976454">{{cite journal| author=Wahls SA| title=Sick sinus syndrome. | journal=Am Fam Physician | year= 1985 | volume= 31 | issue= 3 | pages= 117-24 | pmid=3976454 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3976454 }} </ref>

==Symptoms==
Even though many types of sick sinus syndrome produce no symptoms, patients may present with:
* [[Stokes-Adams attack]]s - fainting due to [[asystole]] or [[ventricular fibrillation]]
* [[Dizziness]] or light-headedness
* [[Palpitations]]
* [[Chest pain]] or [[Angina pectoris|angina]]
* [[Shortness of breath]]
* [[Fatigue]]
* [[Headache]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

Sick sinus syndrome natural history, complications and prognosis

2016-09-26T01:26:22Z

Anis Kadado: /* Natural History, Complications and Prognosis */