Sinus Bradycardia: Medical History

Medical history (history of illness) represents an important component in the diagnosis of sinus bradycardia.

Family history

• Do you have relatives who suffer from cardiac arrhythmias?

Social history

Current medical history/systemic history (somatic and psychological complaints).

• When did bradycardia (= heart rate below 60 beats per minute) first occur?
• When did this occur for the last time?
• How frequently does the bradycardia occur (daily, weekly, monthly)?
• In what situations does bradycardia occur?
• Does the pulse beat regularly or irregularly during bradycardia?
• How long does the bradycardia last?
• What other symptoms do you notice during bradycardia?
  • Dizziness?*
  • Loss or threat of unconsciousness?*

Vegetative anamnesis incl. nutritional anamnesis.

Own anamnesis incl. medication anamnesis

• Previous diseases
  • Cardiac conditions (heart disease): coronary artery disease (CAD; coronary artery disease), heart failure (heart weakness), cardiomyopathies (heart muscle disease), pre-existing arrhythmias;syncope, dizziness.
  • Noncardiac diseases: Hyperthyroidism (hyperthyroidism, neurological diseases, neuromuscular diseases, renal insufficiency (kidney weakness), chronic obstructive pulmonary disease (COPD), glaucoma (glaucoma).
• Operations
• Allergies

Medication history

• Acetylcholinesterase inhibitors (donezepil, galantamine, neostigmine, rivastigmine).
• Alpha-2 agonist (tizanidine).
• Antiarrhythmic drug
  • Ic antiarrhythmics (flecainide, propafenone).
  • Class II antiarrhythmics (atenolol, bisoprolol, metoprolol, propranolol).
  • Class III antiarrhythmics (amiodarone, sotalol)Concurrent therapy with the hepatitis C agent sofosbuvir (HCV polymerase inhibitor) and the antiarrhythmic agent amiodarone may potentially cause life-threatening bradycardia
• Antidepressants (citalopram).
• Antiepileptic drugs
  • Functionalized amino acid (lacosamide).
• Antihypertensives
  • Methyldopa
  • Imidazoline (clonidine)
• Beta-blockers, local (betaxolol, timolol) [eye drops].
• Beta blockers, systemic (acebutolol, atenolol, betaxolol, bisoprolol, carvedilol, celiprolol, esmolol, metoprolol, nadolol, nebivolol, oxprenolol, pindolol, propranolol)
• Calcium antagonists (calcium channel blockers).
  • Benzothiazepines (diltiazem type): diltiazem.
  • Dihydropyridine type: amlodipine
  • Phenylalkylamines (verapamil type).
• Cholinesterase inhibitor (Distigmine).
• Digitalis – digoxin
• Cardiac glycosides (ß-acetyldigoxin, ß-methyldigoxin, digoxin, digitoxin).
• Immunosuppressants (thalidomide).
• Immunotherapeutics (fingolimod)
• Local anesthetics (lidocaine, mepivacaine, procaine).
• Opiates or opioids (alfentanil, apomorphine, buprenorphine, codeine, dihydrocodeine, fentanyl, hydromorphone, loperamide, morphine, methadone, nalbuphine, naloxone, naltrexone, oxycodone, pentazocine, pethidine, piritramide, remifentanil, sufentanil, tapentadol, tilidine, tramadol).
• Muscle relaxants (succinylcholine, tizanidine).
• Lithium
• Parasympathomimetics
  • Indirect parasympathomimetics (cholinesterase inhibitors): alkylphosphates, distigmine, donepezil, galantamine, neostigmine, physostigmine, pyridostigmine, rivastigmine, tacrine
• Sinus node inhibitor (If-channel inhibitors or If-inhibitors): ivabradine.
• Cytostatic drugs (paclitaxel).

Environmental history

• Organophosphates (E605)

* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)