Sick Sinus Syndrome, (Sinus Nodal Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Sick sinus syndrome is a collection of heart rhythm disorders with the sinus node, such as:
1. The heartbeat rate is too slow, called sinus bradycardia
2. The heartbeat pauses or stops, called sinus pauses or sinus arrest
3. Episodes of a fast heart rate
4. Slow heart rhythms that alternate with fast heart rhythms, called bradycardia-tachycardia or "tachy-brady syndrome"
The ECG indicates sinus node dysfunction with an atrial rate that is not suitable for normal functions.
Sick sinus syndrome is normally produced by idiopathic fibrosis of the sinus node.
Sick sinus syndrome most often happens in people older than 50.
It is often caused by scar-like injury to electrical pathways in the heart muscle tissue.
In children, heart surgery on the upper chambers is a frequent cause of sick sinus syndrome.
Coronary heart disease, high blood pressure, and aortic and mitral valve diseases may happen with sick sinus syndrome.
Sinus bradycardia happens more often than the other forms of the disorder.
Tachycardias (rapid heart rates) starting in the upper heart may be part of the syndrome:
1. Atrial fibrillation,
2. Atrial flutter,
3. Atrial tachycardia.
Periods of fast heart rates is often followed by very slow heart rates
Some medicines can worsen abnormal heart rhythms.
These are digitalis, calcium channel blockers, beta-blockers, and anti-arrhythmics.
Causes are:
1. An intrinsic disease of the sinus node:
a. Idiopathic degeneration of the sinus node
b. Collagen vascular disease: amyloidosis, hemochromatosis,sarcoidosis.
c. Familial sinoatrial node disorders
d. Friedreich's ataxia, muscular dystrophy.
e. Cardiomyopathies: ischemia, myocardial infarction, myocarditis, pericarditis, rheumatic heart disease
f. Surgical injury.
2. Extrinsic causes:
a. Hyper-kalemia, hypoxia, hypothermia, hypothyroidism, hyperthyroidism.
b. Drugs - e.g., digoxin
c. Toxins
d. Sleep apnea
Symptoms
Most of the time, no symptoms are present.
Symptoms that do happen may imitate those of other disorders.
1. Chest pain or angina
2. Confusion
3. Fainting or near-fainting
4. Fatigue
5. Dizziness
6. Palpitations
7. Shortness of breath
Diagnosis:
Sick sinus syndrome is diagnosed when the symptoms happen only during episodes of arrhythmia.
An ECG may show abnormal heart rhythms linked to this syndrome.
a. Atrial brady-arrhythmias
b.Atrial tachy-arrhythmias
c. Ventricular (escape) tachy-arrhythmia.
d. Alternating bradycardias and tachycardias
An intra-cardiac electrophysiology study (EPS) is a very specific test for this disorder.
Treatment
The patient may not require treatment if he or she does not have any symptoms.
The patient may require a permanent implanted pacemaker if the symptoms are linked to bradycardia (slow heart rate).
Atrial or dual-chamber pacemakers normally provide successful relief of symptoms and reduce the incidence of atrial fibrillation, thromboembolic events, heart failure and mortality, when compared with ventricular pacemakers
Beta-blockers, quinidine and digoxin may be given together with a pacemaker for tachy-arrhythmias.
Anticoagulation will be required for patients with atrial fibrillation
A fast heart rate (tachycardia) may be treated with medicine.
Occasionally, an intervention called radiofrequency ablation is done to cure tachycardia.
In some cases, medicines given to control periods of fast heart rate are combined with the use of a pacemaker, which protects against periods of slow heart rate.
TABLE OF CONTENT
Introduction
Chapter 1 Sick Sinus Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Atrial Flutter
Chapter 8 Wolff Parkinson White Syndrome
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Sick Sinus Syndrome, (Sinus Nodal Disorder) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Sick Sinus Syndrome,
(Sinus Nodal Disorder)
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2017 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Sick Sinus Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What The patient Need to Treat Sick Sinus Syndrome)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank the patient for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Sick sinus syndrome
What is Sick Sinus Syndrome?
Sick sinus syndrome is a collection of heart rhythm disorders with the sinus node, such as:
1. The heartbeat rate is too slow, called sinus bradycardia
2. The heartbeat pauses or stops, called sinus pauses or sinus arrest
3. Episodes of a fast heart rate
4. Slow heart rhythms that alternate with fast heart rhythms, called bradycardia-tachycardia or tachy-brady syndrome
The ECG indicates sinus node dysfunction with an atrial rate that is not suitable for normal functions.
Sick sinus syndrome is normally produced by idiopathic fibrosis of the sinus node.
Normally, the heartbeat begins in a part of the top chambers of the heart (atria) called the heart's pacemaker.
It is the sinoatrial node, sinus node or SA node.
This SA node keeps the heart beat steady and regular.
What are the causes of Sick Sinus Syndrome?
Causes
Sick sinus syndrome most often happens in people older than 50.
It is often caused by scar-like injury to electrical pathways in the heart muscle tissue.
In children, heart surgery on the upper chambers is a frequent cause of sick sinus syndrome.
Coronary heart disease, high blood pressure, and aortic and mitral valve diseases may happen with sick sinus syndrome.
These diseases may have nothing to do with the syndrome.
Sick sinus syndrome is rare.
Sinus bradycardia happens more often than the other forms of the disorder.
Tachycardias (rapid heart rates) starting in the upper heart may be part of the syndrome:
1. Atrial fibrillation,
2. Atrial flutter,
3. Atrial tachycardia.
Duration of fast heart rates is often followed by very slow heart rates
.
Some medicines can worsen abnormal heart rhythms.
These are digitalis, calcium channel blockers, beta-blockers, and anti-arrhythmics.
Causes are:
1. An intrinsic disease of the sinus node:
a. Idiopathic degeneration of the sinus node is the most frequent cause of sick sinus syndrome.
b. Collagen vascular disease: amyloidosis, hemochromatosis, fatty replacement, sarcoidosis.
c. Familial sinoatrial node disorders: autosomal and recessive forms
d. Friedreich's ataxia, muscular