Sinus bradycardia . Rhythm originating from the sinus node less than 60 beats / min at rest.
Summary
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- 1 Diagnosis
- 2 Etiology
- 3 Clinical and hemodynamic consequences
- 4 Treatment
- 5 Sources
Diagnosis
Regular rate of sinus P waves followed by QRS complexes at a rate less than 60 beats / min.
Etiology
- Sinus disease.
- Carotid sinus hypersensitivity .
- Elderly .
- Hypothyroidism .
- Obstructive jaundice .
- IMA .
- Typhoid fever .
- Depression .
- Endocranial hypertension .
- Beta blockers .
- Calcium antagonists .
- Amiodarone .
- Clonidine .
- Digitalis poisoning .
- Reserpine .
Clinical and hemodynamic consequences
They depend on heart rate and on the existence of an adequate compensatory increase in stroke volume . In turn, stroke volume is related to the overall effectiveness of ventricular systolic function . Therefore, many individuals with normal ventricular function remain asymptomatic at slow heart rates between 40 and 50 beats / min.
Treatment
- They don’t usually need it.
- When they cause hemodynamic changes or in the IMA it is indicated:
- Atropine iv or 5 mg every 5 min up to 2 mg.
- If the arrhythmia persists: isuprel , from 1 to 5 mg in 500 mL of dextrose to 5% drip according to heart rate.
- Transient pacemaker : if hemodynamic deterioration persists.
