Key points about sick sinus syndrome 

  • Sick sinus syndrome is a condition where the sinus node, the heart's natural pacemaker, malfunctions, causing abnormal heart rhythms. 
  • It can result in slow heart rates (bradycardia), fast heart rates (tachycardia) or alternating rhythms, causing symptoms like dizziness and fainting. 
  • Age-related degeneration, heart disease, and certain medications are common causes. 
  • Diagnosis is made with an ECG, Holter monitor and blood tests to assess underlying issues. 
  • Treatment often involves a pacemaker to regulate the heart rate and medications to manage symptoms.
Common related conditions
Atrial Tachycardia Bradycardia Arrhythmia Arrhythmias Sinus Tachycardia

Sick sinus syndrome causes 

Sick sinus syndrome can be caused by: 

  • Degeneration of the sinus node due to aging. 
  • Coronary artery disease or heart attack that damages the heart's conduction system. 
  • Heart surgery or trauma that affects the electrical pathways of the heart. 
  • Use of medications like beta-blockers, calcium channel blockers or digoxin. 
  • Conditions like hypothyroidism or electrolyte imbalances.

Sick sinus syndrome risk factors 

Risk factors include: 
  • Older age, which increases the likelihood of age-related degeneration of the sinus node. 
  • A history of heart disease, including coronary artery disease or heart attacks. 
  • Previous heart surgery that may have affected the heart’s electrical system. 
  • Medications that influence heart rate, like beta-blockers or calcium channel blockers. 
  • Conditions like hypothyroidism, which can affect the heart's conduction system. 

Sick sinus syndrome symptoms 

Common symptoms of sick sinus syndrome are: 
  • Fatigue, weakness or reduced exercise tolerance. 
  • Dizziness, lightheadedness or fainting episodes, especially during bradycardia. 
  • Palpitations or irregular heartbeats during tachycardia episodes. 
  • Shortness of breath, particularly with physical exertion. 
  • Chest discomfort or tightness in some cases. 

Sick sinus syndrome diagnosis 

Sick sinus syndrome is diagnosed using: 

  • An electrocardiogram (ECG or EKG) to monitor heart rhythms and detect irregularities. 
  • A Holter monitor to track heart activity over 24-48 hours for intermittent episodes. 
  • Blood tests to check for thyroid issues, electrolyte imbalances or other underlying conditions. 
  • An echocardiogram to assess the heart's structure and rule out other potential causes of symptoms. 

Sick sinus syndrome treatment 

Treatment for sick sinus syndrome may include: 
  • A pacemaker, which is typically implanted to regulate the heart’s rhythm and prevent bradycardia-related complications. 
  • Medications for any underlying conditions, like thyroid hormone therapy for hypothyroidism. 
  • Adjusting or discontinuing medications that may contribute to the slow heart rate or arrhythmias. 
  • In some cases, antiarrhythmic drugs to control episodes of tachycardia. 

When to seek care 

You should seek medical care if you experience: 

  • Dizziness, fainting or lightheadedness, especially during physical activity. 
  • Palpitations or a racing heart, particularly if associated with chest pain. 
  • Unexplained fatigue or weakness that interferes with daily activities. 
  • Difficulty breathing or shortness of breath, especially with exertion.

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