Sinus bradycardia

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

  1. Sinus disease.
  2. Carotid sinus hypersensitivity .
  3. Elderly .
  4. Hypothyroidism .
  5. Obstructive jaundice .
  6. IMA .
  7. Typhoid fever .
  8. Depression .
  9. Endocranial hypertension .
  10. Beta blockers .
  11. Calcium antagonists .
  12. Amiodarone .
  13. Clonidine .
  14. Digitalis poisoning .
  15. 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

  1. They don’t usually need it.
  2. 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.

 

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