Medical history (history of illness) represents an important component in the diagnosis of sick sinus syndrome (SSS). Family history Do you have relatives who suffer from cardiac arrhythmias? Social history Current medical history/systemic history (somatic and psychological complaints). When did the cardiac arrhythmias first occur? When did the cardiac arrhythmia last occur? What symptoms do … Sick Sinus Syndrome: Medical History
Cardiovascular System (I00-I99). Atrioventricular block Intraventricular block Sinuatrial block Sinus arrhythmia Sinus bradycardia
The following are the most important diseases or complications that may be contributed to by sick sinus syndrome (SSS): Cardiovascular system (I00-I99) Apoplexy (stroke) Heart failure (cardiac insufficiency) Sudden cardiac death (PHT) Jumping to another heart rhythm, including atrial fibrillation (VHF). Psyche – Nervous System (F00-F99; G00-G99). Anxiety
A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes [pallor]. Neck vein congestion? Central cyanosis? (bluish discoloration of skin and central mucous membranes, e.g., tongue). … Sick Sinus Syndrome: Examination
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Electrolytes – potassium, magnesium Thyroid parameters – TSH Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – for … Sick Sinus Syndrome: Test and Diagnosis
There is no drug therapy for sick sinus syndrome. First-line therapy is a pacemaker (see surgical therapy below).
Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of electrical activity of the heart muscle) [possible findings: Severe sinus bradycardia, possibly sinus pauses/stoppage. Alternating tachycardic and bradycardic atrial replacement rhythms. SA/AV conduction abnormalities] Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for … Sick Sinus Syndrome: Diagnostic Tests
1st order Insertion of a pacemaker (pacemaker; usually DDD system) indications for sick sinus syndrome (SSS): Chronic SSS with symptomatic bradycardia (heart rate less than 60 beats per minute); or Pauses > 3 seconds
The following symptoms and complaints may indicate sick sinus syndrome (SSS): Leading symptoms Alternating tachycardic and bradycardic atrial replacement rhythms. Symptoms of bradycardia (heartbeat too slow: < 60 beats per minute). Lack of rate increase during exercise (max. 80-90/min). Vertigo (dizziness) (at rest). Fatigue Syncope (momentary loss of consciousness) Adams-Stokes seizure – syncope (brief loss … Sick Sinus Syndrome: Symptoms, Complaints, Signs
Pathogenesis (disease development) The most common cause of sick sinus syndrome is idiopathic fibrotic degeneration. Sick sinus syndrome (SSS) is cardiac arrhythmias due to impaired function of the sinus node (physiologic pacemaker of the heart) caused by various disease states. The following dysfunctions are grouped under sick sinus syndrome: Sinus bradycardia (< 60 heartbeats per … Sick Sinus Syndrome: Causes
Vaccinations The following vaccinations are advised: Flu vaccination Pneumococcal vaccination Regular checkups Regular medical checkups Psychotherapy If necessary, psychotherapy for anxiety disorders resulting from the disease. Detailed information on psychosomatics (including stress management) can be obtained from us.