Presentation
We present a 2-year-old girl with trisomy 21 who developed the rapid onset of bradycardia during anesthetic induction with sevoflurane. Previous reports are reviewed, postulated mechanisms discussed, and preventative strategies presented. [ncbi.nlm.nih.gov]
When a P wave is present and not followed by a QRS wave (and heart contraction), there is an atrioventricular block, and a very slow pulse (bradycardia). [mountsinai.org]
Session Title: FIT Clinical Decision Making: Arrhythmias and Clinical EP 2 Abstract Category: Arrhythmias and Clinical EP Presentation Number: 1167-220 2019 American College of Cardiology Foundation [onlinejacc.org]
Entire Body System
- Hypothermia
Links: hypothyroidism hypothermia vomiting drug-induced bradycardia hypersensitive carotid sinus syndrome neurocardiogenic syndrome raised intracranial pressure jaundice [gpnotebook.co.uk]
Possible underlying causes of bradycardia include the Hs and Ts: Hypoxia Hydrogen ion (acidosis) Hyperkalemia Hypothermia Heart block Toxins Trauma If necessary, establish an airway to assist with breathing. [aclsonline.us]
RCA territory), hypothyroidism, hypothermia, increased intracranial pressure. (Chanu Rhee MD, 8/26/10) [errolozdalga.com]
The causes of sinus bradycardia include the following: AV blocking medications (beta-blockers, nondihydropyridine calcium channel blockers, digoxin) Heightened vagal tone (i.e. well-trained athlete) Sick sinus syndrome Hypothyroidism Hypothermia Obstructive [healio.com]
Hypothermia. Cushing's reflex (systemic response to raised intracranial pressure, leading to widening pulse pressure, irregular breathing and bradycardia). Acute myocardial infarction. Sick sinus syndrome. Pericardial tamponade. [patient.info]
- Fever
Case Report A 70-year-old male was admitted to our hospital because of a severe headache, fever, and confusion. The patient had been well until 5 hours before admission, when fever up to 39.6°C and mental status change developed. [hindawi.com]
[…] myocardial infarct raised intra-cranial pressure drugs eg beta-blockers, digitalis, hypotensives rapid rise in blood pressure sinoatrial disease ('sick sinus syndrome') transient increase in vagal tone eg after vomiting physical training convalescence from fever [gpnotebook.co.uk]
These patients were diagnosed serologically and analyzed retrospectively: 337 (68.4%) responded to fever with increased heart rate < 10 beats/minute/°C (relative bradycardia [RB]), and 156 patients had a heart rate response ≥ 10 beats/minute/°C (general [ncbi.nlm.nih.gov]
a disease that can develop if strep throat or scarlet fever are not treated properly Collagen vascular diseases, such as lupus, scleroderma or rheumatoid arthritis Pericarditis, a swelling and irritation of the thin saclike membrane surrounding the [community.bulksupplements.com]
Sinus bradycardia during exercise, fever or congestive heart failure is abnormal. [sjo.org]
Liver, Gall & Pancreas
- Jaundice
Links: hypothyroidism hypothermia vomiting drug-induced bradycardia hypersensitive carotid sinus syndrome neurocardiogenic syndrome raised intracranial pressure jaundice [gpnotebook.co.uk]
Bradycardia can also occur secondary to certain illnesses (such as decreased thyroid function, certain gastrointestinal disorders, and jaundice), or the abuse of certain drugs. [healthcentral.com]
Severe obstructive jaundice. Pleural or peritoneal stimulation. Rarely, infection (eg, typhoid may cause relative bradycardia). Ectopic atrial rhythm or wandering atrial pacemaker Ectopic atrial foci, if ≥3 foci = wandering atrial pacemaker. [patient.info]
Neurologic
- Irritability
The most common reported toxicities with SCB use based on studies using Texas Poison control record are tachycardia, agitation and irritability, drowsiness, hallucinations, delusions, hypertension, nausea, confusion, dizziness, vertigo, chest pain, acute [ncbi.nlm.nih.gov]
[…] pacemaker, is not functioning properly Rheumatic fever; a disease that can develop if strep throat or scarlet fever are not treated properly Collagen vascular diseases, such as lupus, scleroderma or rheumatoid arthritis Pericarditis, a swelling and irritation [community.bulksupplements.com]
Risks There are no significant risks involved in wearing a Holter monitor other than possible discomfort or skin irritation where the electrodes were placed. However, the Holter monitor can't get wet, or it will be damaged. [mayoclinic.org]
Pain in the trigeminal system: irritation of the nasal mucosa using short- and long-lasting stimuli. Int J Psychophysiol 47 : 147–158, 2003. Crossref ISI Google Scholar 102. [doi.org]
- Forgetful
Man cannot forget your sacrifice. [urdushahkar.org]
If this area is not mature, the baby may forget to breathe. About 45 percent of babies weighing less than 5 ½ pounds will have at least some apnea. If the baby was less than 2 ½ pounds up to 85 percent will have apnea in the first few weeks of life. [pediatrics.emory.edu]
Poor blood supply to the brain may cause a feeling of dizziness or lightheadedness, confusion and forgetfulness, poor memory and trouble concentrating or changes in consciousness. [drweil.com]
Don't forget to get a good medication history, focusing on recent medication changes and drugs which can accumulate in renal dysfunction (e.g. digoxin, atenolol). Don't be fooled by transcutaneous pacemaker pseudocapture. [emcrit.org]
- Lethargy
Although this may be a coincidental finding it usually presents with lethargy and syncope. It signifies significant fibrosis or ischaemia in the AV node and requires a permanent pacemaker. [rcemlearning.co.uk]
- Memory Impairment
The symptoms of more serious forms may include: Fatigue and weakness Fainting and near fainting Dizziness and light-headedness Shortness of breath Chest pain Disturbed sleep Confusion or memory impairment Difficulty walking, climbing stars or exercising [cardiovascular.abbott]
- Hyperactivity
Acute fluid shift from the splanchnic vasculature to central vasculature may have occurred causing HELLP syndrome as a result from vasospasm associated with sympathetic hyperactivity. [ncbi.nlm.nih.gov]
Workup
Subsequent cardiac workup showed no abnormalities. We believe the cause of arrest was sugammadex, considering the time of administration, the absence of cardiac disease, and stable operative course. [ncbi.nlm.nih.gov]
Serologic titers for various infectious diseases such as Lyme disease may be helpful in a short-term capacity, but since the results will not be available immediately, they are not essential in the initial diagnostic workup. [reliasmedia.com]
Treatment
Learn how it's diagnosed, and what treatments can help. Treatments Treatment for bradycardia depends on what is causing it and the severity of your symptoms. The goal of treatment is to raise your heart rate so your body gets the blood it needs. [vidanthealth.com]
Treatments Treatment for bradycardia varies from person to person and depends upon the severity, frequency and cause of the slower heart rate. Treatment for a slow heartbeat is a pacemaker. [wexnermedical.osu.edu]
Bradycardia Treatment Bradycardia treatment depends on your test results. Your doctor at the UPMC Heart and Vascular Institute's Cardiac Electrophysiology Program will go over your test results and discuss treatment options. [upmc.com]
Treatment. It rarely requires treatment unless it causes symptoms. Then, a pacemaker may be implanted if there is no cause that can be easily treated. [cigna.com]
Dopamine agonists (DAs) are efficacious for the treatment of motor and nonmotor symptoms in patients with Parkinson's disease (PD). [ncbi.nlm.nih.gov]
Prognosis
The lower the fetal heart rate, the worse the prognosis. [radiopaedia.org]
BACKGROUND: The prognosis of super-elderly patients (age≥85 years) who undergo bradycardia pacemaker (PM) implantation remains unknown. [ncbi.nlm.nih.gov]
Bradycardia can also be produced by drugs such as digitalis or morphine and is a common abnormality in heart attack victims, for whom it often indicates a favourable prognosis. [britannica.com]
Prognosis for bradycardia resulting from extrinsic influences on the heart largely depends upon the underlying diagnosis. [accessmedicine.mhmedical.com]
Etiology
Etiology Sinus bradycardia has many intrinsic and extrinsic etiologies[5]][6][7][8][9][10]. [ncbi.nlm.nih.gov]
Consider this diagnosis in patients without other etiologies of conduction disorders. [reliasmedia.com]
Epidemiology
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
One in 600 adults over the age of 65 has sinus node dysfunction, but more research needs to be done to collect epidemiologic data within the United States and globally for patients with sinus bradycardia.[11] Pathophysiology Sinus bradycardia as any of [ncbi.nlm.nih.gov]
Epidemiology It is impossible to give meaningful figures on incidence and prevalence. In most young people bradycardia is physiological and represents athletic training. [patient.info]
[…] epinephrine) or transcutaneous pacing should be used.[13] Transvenous pacing may be required if the cause of the bradycardia is not rapidly reversible.[13] In children, giving oxygen, supporting their breathing, and chest compressions are recommended.[14][15] Epidemiology [en.wikipedia.org]
Pathophysiology
This case report highlights the occurrence of this complication during a routine removal of a true vocal fold lesion at a tertiary medical center and discusses the potential pathophysiological mechanisms and proposed management options for this phenomenon [ncbi.nlm.nih.gov]
In this article, we will briefly review the clinical presentation, pathophysiology, diagnostic evaluation, and treatment of patients with bradycardia.Clinical PresentationCardiac output is the left ventricular forward stroke volume multiplied by the heart [doi.org]
The pathophysiology of sinus bradycardia is dependent on the underlying cause. [1] Commonly, sinus bradycardia is an incidental finding in otherwise healthy individuals, particularly in young adults, athletes or sleeping patients. [2] Other causes of [emedicine.com]
Prevention
Prevention Taking steps to prevent coronary artery disease may reduce your chance of developing an arrhythmia. [mountsinai.org]
Highly trained athletes may also have athletic heart syndrome, a very slow resting heart rate that occurs as a sport adaptation and helps prevent tachycardia during training. [dbpedia.org]
Treatment may include a pacemaker to prevent the heart from beating too slowly. Medicines might be used to prevent the heart from beating too fast. Blood-thinning medicines might be used to help prevent a stroke. [cigna.com]
Previous reports are reviewed, postulated mechanisms discussed, and preventative strategies presented. [ncbi.nlm.nih.gov]
Bradycardia prevention Bradycardia can’t always be prevented. You may help prevent bradycardia by lowering your risk of heart disease. [healthdirect.gov.au]