Sick Sinus syndrome

Sick Sinus syndrome

1. Signs and symptoms

   • unconsciousness /Syncope (causes)
     • No-cardiac
       • Toxic
         • Endogenous toxicosis
         • Exogenous toxicosis
       • Endocrine
         • Hypoglycaemia
         • Hyperglycaemia
       • Cerebral
         • Epilepsy
         • Apoplexy
         • Intracerebral bleeding
       • Psychical
         • Hysteria
       • Anoxaemic
         • Asphyxia
       • Others
         • Alcohol
         • Exercise
     • Cardiac
       • Stroke
       • Shock
       • Cardiac arrest
   • Dyspnea
   • Chest pain

2. Psychology

   • Threat to employment and financial status
   • Frightening from Life threatening event
   • Reduced life expectancy
   • Being treated differently by other people
   • Fears for family and partner being left alone
   • Depression

3. Diagnosis

   • Investigation
     • ECG
       • Normal
       • SSS
     • chest x-ray
     • cardiac CT
     • Cardiac MI
     • Echocardiogram
     • Angiography
   • History taking

4. Treatment

   • CPR
     • 1.Check the scene and the person 2.Call 998 for assistance 3.Check for breathing 4.Open the airway 5.Push hard, push fast 6.Deliver rescue breaths 7.Continue CPR steps
   • Non-surgical (anti-arrythmia drugs)
     • Amiodarone
   • Surgical (artificial pacemaker)
     • Temporary
       • Heart attack
       • heart surgery
       • overdose
     • Permanent
       • bradycardia
       • heart block
   • Life style changes

5. Physiology

   • Mechanism of excitation, contraction & coupling
   • Cardiac action potential
   • Pacemaker physiology
     • 60 - 100 b/m
     • 40 - 60 b/m
     • 20 - 45 b/m
   • Conduction system of the heart
     • SA node
       • AV node
         • bundle of his
           • bundle branches
             • Purkinje fibers
   • Electrical behavior of the myocardium
     • anatomy
       • Atrial msucle
       • Ventricular muscle
       • Specialized excitatory /conductive muscle fibers
     • Special structures
       • Intercalated discs
       • gap junctions
     • mechanism
       • has long action potential and plateau
       • Refractory Period of Cardiac Muscle is longer
         • Absolute refractory period
         • Relative refractory period
       • Calcium Ions and the Transverse Tubules

6. Definition

   • Group of disorders that are caused by malfunction of the sinus node

7. Types

   • Sinus Tachycardia
   • Sinus Bradychardia
   • Sinus arrest
   • Sinus Bradychardia-Tachychardia

8. Causes

   • Fibrosis of SA node
   • Acute MI
   • Myocarditis

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