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Sick Sinus Syndrome

(SSS; Bradycardia-Tachycardia Syndrome; Sinus Node Dysfunction)

Definition

Sick sinus syndrome (SSS) is not 1 specific disease. It is the term is used to describe several heart rhythm disorders. Sick sinus syndrome disorders include:
Anatomy of the Heart
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Causes

Sick sinus syndrome (SSS) is caused by a problem with the electrical signals of the heart. The problem begins in an area of the heart called the sinoatrial (SA) node. This node is considered to be the heart’s natural pacemaker. When the SA node is defective, the heart’s rhythms become abnormal. The dysfunction in the SA node can be due to:

Risk Factors

Sick sinus syndrome (SSS) is fairly rare. It occurs most often in elderly people and those who have had damage to the heart tissue. Although rare, infants and children can have SSS. In this case, it is usually due to congenital abnormalities in the heart. Certain medications may worsen symptoms.

Symptoms

Often, sick sinus syndrome (SSS) doesn't have symptoms. Some people may experience a period of very rapid heart beats followed by very slow heart rate. Many of the symptoms of sick sinus disorder are mild and nonspecific. Some symptoms associated with SSS include:
These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor.

Diagnosis

Sick sinus syndrome (SSS) may go undetected for some time. The symptoms are similar to ones for many disorders. Your doctor can do tests that will help to give a more definitive diagnosis. Most likely, your doctor will ask about your symptoms and medical history. A physical exam will be done. Some additional tests may include the following:

Treatment

For people with no symptoms, treatment may not be needed. SSS is a progressive disorder. It can further weaken the muscles of the heart in people with previous heart damage. This can lead to heart failure. As a result, people with symptoms are treated. Most treatment plans involve separate therapy for bradycardia and tachycardia. Talk with your doctor about the best plan for you. Treatment options include the following:

Pacemaker Insertion

A pacemaker is a small, battery-operated device. Electrodes from the pacemaker are placed in the right side of the heart. Signals are sent to the electrodes to stimulate the heart. It helps to maintain a normal heartbeat by sending electrical impulses to the heart. It is a very effective treatment of bradycardia. People with implanted pacemakers have a very good prognosis.

Medication

Medication may be given to control tachycardia. It is most often given to people with a pacemaker.

Prevention

For most people, sick sinus syndrome is not preventable. It may not be caused by prior damage or scarring to the heart tissue. However, some strategies for minimizing your chance of developing this condition include:

RESOURCES

American Heart Association http://www.heart.org

Heart Rhythm Society http://www.hrsonline.org

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca

Heart and Stroke Foundation of Canada http://www.heartandstroke.com

References

Adan V, Crown LA. Diagnosis and treatment of sick sinus syndrome. Am Fam Physician. 2003;67(8):1725-1738.

Sick sinus syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 21, 2014. Accessed December 30, 2014.

Sick sinus syndrome. Heart Rhythm Society website. Available at: http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Sick-Sinus-Syndrome#axzz3NOr35s6f. Accessed December 30, 2014.

Sinus node dysfunction. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/cardiovascular%5Fdisorders/arrhythmias%5Fand%5Fconduction%5Fdisorders/sinus%5Fnode%5Fdysfunction.html. Updated September 2013. Accessed December 30, 2014.

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