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]

• Pain

  A 37-year-old man suffered irreversible profound symptomatic bradycardia requiring a pacemaker 3 days after beginning tizanidine/loxoprofen combination therapy for neck pain. [ncbi.nlm.nih.gov]

  […] blood flow to the heart Call 911 if you experience: Shortness of breath Pain or pressure in the chest Feeling lightheaded, dizzy or faint It’s very important to tell your doctor how you’re feeling — even if symptoms are mild. [cardiosmart.org]

  *Chest pain or pressure is a medical emergency. Contact a physician or emergency services if you have questions or are concerned about any symptoms. [alivecor.zendesk.com]

  […] of chest pain or collapse. [patient.info]

• Fatigue

  When symptomatic, it may cause fatigue, weakness, dizziness, and at very low rates, fainting. During sleep, a slow heartbeat with rates around 40–50 BPM is common, and is considered normal. [dbpedia.org]

  Bradycardia can cause fatigue and other symptoms. If it’s serious enough, it can cause cardiac arrest and death. Symptoms A slow heartbeat doesn’t always cause symptoms. [urmc.rochester.edu]

  When symptomatic, it may cause fatigue, weakness, dizziness, and at very low rates fainting. [osmosis.org]

  dizziness, and alternating periods of bradycardia and atrial tachycardia, which is caused by sinoatrial node dysfunction A constellation of signs and symptoms which may include syncope, fatigue, dizziness, and alternating periods of bradycardia and [icd9data.com]

  Common SSS Include: Rapid, fluttering, irregular heartbeats Fatigue Weakness Fainting and near fainting Dizziness and light-headedness Shortness of breath Chest pains Insomnia Confusion and memory issues Causes of SSS Include: Scar tissue from previous [cardiovascular.abbott]

• 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]

  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]

  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]

• Falling

  On the 49th day of terbinafine therapy, he was brought to the emergency room for a decrease of his global health status, confusion and falls. The electrocardiogram revealed a 37 beats/min sinus bradycardia. [ncbi.nlm.nih.gov]

  Your heart rate may fall below 60 BPM during deep sleep. And physically active adults (and athletes) often have a resting heart rate slower than 60 BPM. View an animation of bradycardia. [heart.org]

  But about a year ago, her schedule was suddenly interrupted when she began falling down on the job — literally. “It’s pretty scary when you are walking through the school, and the next thing you know, you’re flat on your face,” she recalls. [everydayhealth.com]

• Amyloidosis

  Lyme disease, diphtheria, typhoid fever) Autoimmune (e.g. systemic lupus erythematosis) Infiltrative disorders (e.g. sarcoidosis, amyloidosis) Physiological causes (e.g. athletes, vagal stimuli) About Chris Nickson FCICM FACEM BSc(Hons) BHB MBChB MClinEpid [lifeinthefastlane.com]

  Heart damage caused by a heart attack or heart disease A condition such as amyloidosis or hemochromatosis Problems with your heart node (tissue that generates electrical signals) Conditions that affect how electrical signals travel between atria and ventricles [drugs.com]

  Clinicians should also evaluate patients for signs of hypothyroidism, any infiltrative disease (e.g., sarcoidosis or amyloidosis) or rheumatologic diseases if the patient’s history is suggestive of these processes as the underlying etiology of the bradycardia [cancertherapyadvisor.com]

  Inherent Etiologies Chest trauma Ischemic heart disease Acute myocardial infarction Acute and chronic coronary artery disease Repair of congenital heart disease Sick sinus syndrome Radiation therapy Amyloidosis Pericarditis Lyme disease Rheumatic fever [ncbi.nlm.nih.gov]

• Dyspnea

  Aminophylline may be considered for reversal of dyspnea and bradyarrhythmia associated with ticagrelor therapy through alterations in adenosine exposure. [ncbi.nlm.nih.gov]

  When symptoms arise, they manifest as fatigue, dizziness and dyspnea on exertion (including chronotropic incompetence). Severe sinus bradycardia is a form of sick sinus syndrome, and a pacemaker would relieve any associated symptoms. [healio.com]

  Case A 67 year old athletic male presented with exertional dyspnea and lightheadedness. ECG and inpatient telemetry showed sinus bradycardia/junctional rhythm, frequent polymorphic PVCs (40% burden) and pauses of 2.9 seconds. [onlinejacc.org]

  Within 48 h of starting this treatment, the patient developed a general malaise, intense astenia, and dyspnea at rest. [revespcardiol.org]

  […] that may occur when the arrhythmia is present include: Chest pain Fainting Lightheadedness, dizziness Paleness Palpitations (feeling your heart beat fast or irregularly) Shortness of breath Sweating A wide range of symptoms, including palpitations, dyspnea [mountsinai.org]

• Tachypnea

  Because hypoxemia is a common cause of bradycardia, initial evaluation of any patient with bradycardia should focus on signs of increased work of breathing (tachypnea, intercostal retractions, suprasternal retractions, paradoxical abdominal breathing) [doi.org]

• Choking

  Hypoxia is a medical emergency, and it can occur when a person is choking or having a severe asthma attack. Chronic medical conditions, such as chronic obstructive pulmonary disease, may also cause hypoxia. [medicalnewstoday.com]

• Heart Disease

  […] developing heart disease. [mayoclinic.org]

  Heart disease Damage to the heart from congestive heart failure, coronary artery disease, previous heart attacks, and other heart problems may affect the heart's electrical system, making the heart pump more slowly and less effectively. [medicalnewstoday.com]

  IOB is common in maxillofacial, ear, nose and throat surgery, particularly in male, older age and patients with ishemic heart disease. The ear surgery, longer anesthesia duration and controlled hypotension raise the risk for occurrence of IOB. [ncbi.nlm.nih.gov]

• Chest Pain

  CONCLUSIONS: Chest pain patients with bradycardia have increased HRV compared to those without bradycardia. [ncbi.nlm.nih.gov]

  *Chest pain or pressure is a medical emergency. Contact a physician or emergency services if you have questions or are concerned about any symptoms. [alivecor.zendesk.com]

  Common SSS Include: Rapid, fluttering, irregular heartbeats Fatigue Weakness Fainting and near fainting Dizziness and light-headedness Shortness of breath Chest pains Insomnia Confusion and memory issues Causes of SSS Include: Scar tissue from previous [cardiovascular.abbott]

  The most common symptoms include: Dizziness or lightheadedness Fainting Fatigue Chest pain Feeling confused or having trouble concentrating Breathlessness Getting tired easily during physical activity If you have chest pains, severe shortness of breath [pinnaclehealth.org]

• Tachycardia

  Some of the more common abnormal heart rhythms are: Atrial fibrillation or flutter Atrioventricular nodal reentry tachycardia (AVNRT) Heart block or atrioventricular block Multifocal atrial tachycardia Paroxysmal supraventricular tachycardia Sick sinus [mountsinai.org]

  Tachycardia‑bradycardia syndrome (TBS) is a complication of SSS characterized by alternating tachycardia and bradycardia. [ncbi.nlm.nih.gov]

  It may be associated with bradycardia-tachycardia syndrome. [icd9data.com]

• Heart Block

  Degrees of Heart Block There are three different degrees or levels of heart block: First-degree heart block: All of the electrical impulses from the upper chambers of the heart reach the lower chambers, but they are slower than normal. [cardiovascular.abbott]

  Heart Block The second general type of bradycardia is heart block. In contrast to sinus bradycardia, which in most people is actually quite normal, heart block is always an abnormal condition. [verywellhealth.com]

  A 2:1 heart block means that for every two contractions of the atria, there's only one contraction of the ventricles. Complete heart block means there is no communication between the upper and lower chambers of the heart. [hopkinsmedicine.org]

  This may cause some symptoms Third Degree Heart Block - (also called Complete Heart Block). The impulses from the upper chambers are "blocked," and none get through to the lower chambers. [hrsonline.org]

  Heart block is another cause of bradycardia that occurs when impulses flowing through the AV node to the ventricles are blocked. Also called AV block, this condition is divided into categories depending on its severity. [news-medical.net]

• Hypotension

  Patients with controlled hypotension had IOB significantly more often than patients without controlled hypotension (33.9 vs 15.1%) (p = 0.000). [ncbi.nlm.nih.gov]

• Blurred Vision

  C reports dizziness, lightheadedness, blurred vision, and nausea worsening over the last few days, and he appears drowsy and hypoactive. [mdedge.com]

  It must be remembered that atropine is not a short acting drug and has an elimination half life of 2 to 3 hours, thus side effects such as a dry mouth, blurred vision and resting tachycardia will be prolonged. [rcemlearning.co.uk]

• Dizziness

  As a result, you may feel dizzy or have chronic lack of energy, shortness of breath, or even fainting spells. CAUSES Bradycardia can occur for several reasons. [medtronic.com]

  When symptomatic, it may cause fatigue, weakness, dizziness, and at very low rates, fainting. During sleep, a slow heartbeat with rates around 40–50 BPM is common, and is considered normal. [dbpedia.org]

  […] blood flow to the heart Call 911 if you experience: Shortness of breath Pain or pressure in the chest Feeling lightheaded, dizzy or faint It’s very important to tell your doctor how you’re feeling — even if symptoms are mild. [cardiosmart.org]

  You feel dizzy, lightheaded, or like you might faint. You have shortness of breath that is new or getting worse. [uofmhealth.org]

• Stroke

  Between the JB patients(with or without retrograde P wave) and controls, we compared incidences of ischemic stroke and a composite of ischemic stroke, renal infarction, ischemic colitis, acute limb ischemia, and pulmonary embolism. [ncbi.nlm.nih.gov]

  Olympic sprinter shares his stroke story Learn the warning signs of stroke No bones about it: It’s time to fight heart disease with Best Friend Fridays The American Heart Association’s new effort looks to put pets in the workplace, while helping raise [heart.org]

  In normal, healthy individuals, stroke volume is preload dependent, and therefore increased PEEP can decrease cardiac output by decreasing stroke volume. 8 The decrease in preload due to PEEP is due to decreased systemic venous return to the right heart [rc.rcjournal.com]

• Seizure

  Propofol infusion was tried with no respite in seizures. Later thiopentone sodium was reintroduced after inserting temporary cardiac pacemaker. Seizure was controlled and patient was weaned off the ventilator. [ncbi.nlm.nih.gov]

  Alterations in cardiac rhythm have been reported in epileptic seizures and taquycardia is the most common finding associated with them; bradyarrhythmia during seizures was uncommon. [scielo.br]

• 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]

• Agitation

  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]

  It is therefore unsuitable for agitated patients. Temporary pacing wires are sized from 4–6 F. Thinner wires are less traumatic but less stable, whereas thicker wires carry a higher risk of perforation (fig. 7). [cardiovascmed.ch]

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]

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]

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 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]

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]

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 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]