Sick sinus syndrome causes: Difference between revisions

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{{Sick sinus syndrome}}
{{Sick sinus syndrome}}
{{CMG}}; {{AE}} {{Ochuko}}
{{CMG}}; {{AE}} {{Sahar}} {{Ochuko}}


==Overview==
==Overview==
Sick sinus syndrome can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, [[sinus bradycardia]], and other types of [[bradycardia]] (slow heart rate).  Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as [[paroxysmal supraventricular tachycardia ]] (PSVT) and atrial fibrillation. Tachycardias that occur with sick sinus syndrome are characterized by a long pause after the tachycardia.
Sick sinus syndrome can result in many abnormal heart rhythms ([[arrhythmias]]), including [[sinus arrest]], [[sinus node exit block]], [[sinus bradycardia]], and other types of [[bradycardia]] (slow heart rate).  Sick sinus syndrome may also be caused by a variety of [[conditions]] including but not limited to [[myocardial infarction]], [[atrial fibrillation]], [[drugs]] or toxins, [[infections]],[[medications]], [[electrolyte abnormalities]], [[hypothermia]], [[hypoxemia]], [[hypercarbia]], and [[acidosis]].
 
==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Life-threatening causes include [[conditions]] which may result in death or permanent disability within 24 hours if left untreated.
*[[Myocardial infarction]]
*[[Myocardial infarction]]
*[[Myocarditis]]
*[[Myocarditis]]
===Common Causes===
===Common Causes===
*[[Beta blockers]]
Common [[causes]] of sick sinus syndrome include:<ref name="pmid6406388">{{cite journal |vauthors=Weintraub M, Hes JP, Rotmensch HH, Soferman G, Liron M |title=Extreme sinus bradycardia associated with lithium therapy |journal=Isr. J. Med. Sci. |volume=19 |issue=4 |pages=353–5 |date=April 1983 |pmid=6406388 |doi= |url=}}</ref><ref name="pmid7018848">{{cite journal |vauthors=Thormann J, Neuss H, Schlepper M, Mitrovic V |title=Effects of clonidine on sinus node function in man |journal=Chest |volume=80 |issue=2 |pages=201–6 |date=August 1981 |pmid=7018848 |doi=10.1378/chest.80.2.201 |url=}}</ref><ref name="pmid15949188">{{cite journal |vauthors=Puljiz I, Beus A, Kuzman I, Seiwerth S |title=Electrocardiographic changes and myocarditis in trichinellosis: a retrospective study of 154 patients |journal=Ann Trop Med Parasitol |volume=99 |issue=4 |pages=403–11 |date=June 2005 |pmid=15949188 |doi=10.1179/136485905X36307 |url=}}</ref><ref name="pmid17570992">{{cite journal |vauthors=Assimakopoulos SF, Michalopoulou S, Papakonstantinou C, Lekkou A, Syrokosta I, Gogos C |title=A case of severe sinus bradycardia complicating anicteric leptospirosis |journal=Am. J. Med. Sci. |volume=333 |issue=6 |pages=381–3 |date=June 2007 |pmid=17570992 |doi=10.1097/MAJ.0b013e3180659578 |url=}}</ref><ref name="pmid15761461">{{cite journal |vauthors=Cunha BA, Thermidor M, Mohan S, Valsamis AS, Johnson DH |title=Fever of unknown origin: subacute thyroiditis versus typhoid fever |journal=Heart Lung |volume=34 |issue=2 |pages=147–51 |date=2005 |pmid=15761461 |doi=10.1016/j.hrtlng.2004.07.003 |url=}}</ref><ref name="pmid11284920">{{cite journal |vauthors=Cunha BA |title=The diagnostic significance of relative bradycardia in infectious disease |journal=Clin. Microbiol. Infect. |volume=6 |issue=12 |pages=633–4 |date=December 2000 |pmid=11284920 |doi=10.1046/j.1469-0691.2000.0194f.x |url=}}</ref><ref name="pmid23939447">{{cite journal| author=Semelka M, Gera J, Usman S| title=Sick sinus syndrome: a review. | journal=Am Fam Physician | year= 2013 | volume= 87 | issue= 10 | pages= 691-6 | pmid=23939447 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23939447  }} </ref><ref name="RubensteinSchulman1972">{{cite journal|last1=Rubenstein|first1=Joel J.|last2=Schulman|first2=Charles L.|last3=Yurchak|first3=Peter M.|last4=Desanctis|first4=Roman W.|title=Clinical Spectrum of the Sick Sinus Syndrome|journal=Circulation|volume=46|issue=1|year=1972|pages=5–13|issn=0009-7322|doi=10.1161/01.CIR.46.1.5}}</ref>
*[[Calcium channel blockers]]
*[[Coronary artery disease]]
*[[sinus node disease|Sinus node fibrosis]]


===Causes by Organ System===
*[[Atrial fibrillation]]
 
*Athletic training
{|style="width:80%; height:100px" border="1"
*[[Drugs]] or toxins, including:
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
**[[Toluene]]
|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]]
**[[Organophosphates]]
|-
**[[Tetrodotoxin]]
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
**[[Cocaine]]
|bgcolor="Beige"| [[Grayanotoxin]], [[rhododendron|rhododendron sp]]
*[[Infections]]:
|-
**[[Lyme disease]]
|-bgcolor="LightSteelBlue"
**[[Legionella]]
| '''Dental'''
**[[Psittacosis]]
|bgcolor="Beige"| No underlying causes
**[[Typhoid fever]]
|-
**[[Typhus]]
|-bgcolor="LightSteelBlue"
**[[Listeria]]
| '''Dermatologic'''
**[[Malaria]]
|bgcolor="Beige"| [[Lyme disease]], [[systemic lupus erythematosus]]
**[[Leptospirosis]]
|-
**[[Dengue fever]]
|-bgcolor="LightSteelBlue"
**viral hemorrhagic fevers
| '''Drug Side Effect'''
**[[Guillain-Barre]]
|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]]
*[[Medications]]:
|-
**[[Beta blockers]]
|-bgcolor="LightSteelBlue"
**[[Calcium channel blockers]]
| '''Ear Nose Throat'''
**[[Digoxin]]
|bgcolor="Beige"| No underlying causes
**[[Sympatholytic medications]]
|-
**[[Antiarrhythmic medications]]
|-bgcolor="LightSteelBlue"
**[[Lithium]]
| '''Endocrine'''
*[[Cardiac surgery]]
|bgcolor="Beige"| [[Amyloidosis]], [[hemochromatosis]], [[hypocalcemia]], [[hypothyroidism]]
*Electrolyte abnormalities
|-
*[[Hypothermia]]
|-bgcolor="LightSteelBlue"
*[[Hypoxemia]], hypercarbia, [[acidosis]]
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Hemochromatosis]], [[sarcoidosis]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Friedreich ataxia]], [[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===
*[[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]]
*[[Coronary artery disease]]
*[[Digitalis]]
*[[Diphtheria]]
*[[Disopyramide]]
*[[Ebstein anomaly]]
*[[Electrolyte imbalance]]
*[[Friedreich ataxia]]
*[[Grayanotoxin]]
*[[Guanethidine]]
*[[HCN4|HCN4 mutation]]
*[[Hemochromatosis]]
*[[Hyperkalemia]]
*[[Hypertension]]
*[[Hypocalcemia]]
*[[Hypothermia]]
*[[Hypothyroidism]]
*[[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]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Crowdiagnosis]]
[[Category:Crowdiagnosis]]
[[Category:Electrophysiology]]
[[Category:Electrophysiology]]

Latest revision as of 23:21, 29 March 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ogheneochuko Ajari, MB.BS, MS [3]

Overview

Sick sinus syndrome can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia (slow heart rate). Sick sinus syndrome may also be caused by a variety of conditions including but not limited to myocardial infarction, atrial fibrillation, drugs or toxins, infections,medications, electrolyte abnormalities, hypothermia, hypoxemia, hypercarbia, and acidosis.

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

Common causes of sick sinus syndrome include:[1][2][3][4][5][6][7][8]

References

  1. Weintraub M, Hes JP, Rotmensch HH, Soferman G, Liron M (April 1983). "Extreme sinus bradycardia associated with lithium therapy". Isr. J. Med. Sci. 19 (4): 353–5. PMID 6406388.
  2. Thormann J, Neuss H, Schlepper M, Mitrovic V (August 1981). "Effects of clonidine on sinus node function in man". Chest. 80 (2): 201–6. doi:10.1378/chest.80.2.201. PMID 7018848.
  3. Puljiz I, Beus A, Kuzman I, Seiwerth S (June 2005). "Electrocardiographic changes and myocarditis in trichinellosis: a retrospective study of 154 patients". Ann Trop Med Parasitol. 99 (4): 403–11. doi:10.1179/136485905X36307. PMID 15949188.
  4. Assimakopoulos SF, Michalopoulou S, Papakonstantinou C, Lekkou A, Syrokosta I, Gogos C (June 2007). "A case of severe sinus bradycardia complicating anicteric leptospirosis". Am. J. Med. Sci. 333 (6): 381–3. doi:10.1097/MAJ.0b013e3180659578. PMID 17570992.
  5. Cunha BA, Thermidor M, Mohan S, Valsamis AS, Johnson DH (2005). "Fever of unknown origin: subacute thyroiditis versus typhoid fever". Heart Lung. 34 (2): 147–51. doi:10.1016/j.hrtlng.2004.07.003. PMID 15761461.
  6. Cunha BA (December 2000). "The diagnostic significance of relative bradycardia in infectious disease". Clin. Microbiol. Infect. 6 (12): 633–4. doi:10.1046/j.1469-0691.2000.0194f.x. PMID 11284920.
  7. Semelka M, Gera J, Usman S (2013). "Sick sinus syndrome: a review". Am Fam Physician. 87 (10): 691–6. PMID 23939447.
  8. Rubenstein, Joel J.; Schulman, Charles L.; Yurchak, Peter M.; Desanctis, Roman W. (1972). "Clinical Spectrum of the Sick Sinus Syndrome". Circulation. 46 (1): 5–13. doi:10.1161/01.CIR.46.1.5. ISSN 0009-7322.

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