Sinus Bradycardia


Pathology:                  Sinus rhythm at a rate <60bpm


Aetiology:                     Normal: athletes or during sleep

Secondary to drug therapy: Beta blockers, digoxin, calciumchannel blockers and anti-arrhythmics)

Other: MI,sick sinus syndrome, hypothyroidism and hypothermia


Symptoms:                   Asymptomatic innon-pathological conditions

                                        Symptomatic patients note SOB, pre-syncope,syncope, chest pain


Signs:                              Slow regular pulse, tachycardia,hypotension, and audible third heart sound.


Investigations:          Bloods:FBC, TFTs, Digoxin levels

ECG: Holtermonitor for 24 hour recording if required.


Treatment:                  IV atropine

Betablocker overdose: Glucagon

                                          Digoxin toxicity: Digibind

                                          Chronic: Temporary pacing wire orpermanent pacemaker


Complications:          Usually none


Prognosis:                  Usually good























Figure 1.7 Sinus Bradycardia

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