What is sick sinus syndrome?
Sick sinus syndrome (SSS) is a group of heart rhythm disorders that occur due to malfunction of the sinus node (the heart’s natural pacemaker). The condition can cause abnormal heart rates, like a slow heart rate (bradycardia), a fast heart rate (tachycardia) or a combination of both. Symptoms can vary, ranging from mild dizziness to severe fainting episodes, and may require a pacemaker for management.Common related conditions
Causes of sick sinus syndrome
Sick sinus syndrome is often caused by:
- Age-related changes in the sinus node and the heart's electrical system.
- Coronary artery disease that can damage the heart’s conduction pathways.
- Heart surgery or prior heart attack that affects the sinus node.
- Certain medications, like beta-blockers or calcium channel blockers, that can slow down your heart rate.
- Conditions like hypothyroidism or electrolyte imbalances.
Risk factors for sick sinus syndrome
Risk factors for developing sick sinus syndrome include:- Older age, as the risk of degeneration in the sinus node increases with age.
- A history of heart disease, such as coronary artery disease or previous heart attacks.
- Previous heart surgery, especially surgery that affects the electrical pathways of the heart.
- Certain medications that impact heart rate, including beta-blockers, calcium channel blockers or digoxin.
- Conditions like hypothyroidism or electrolyte imbalances.
Symptoms of sick sinus syndrome
Symptoms of sick sinus syndrome can include:
- Fatigue or weakness, especially with exertion.
- Dizziness, lightheadedness or fainting (syncope), particularly during episodes of bradycardia.
- Heart palpitations or the sensation of a racing heart during tachycardia episodes.
- Shortness of breath or difficulty breathing normally when exercising.
- Chest pain or discomfort in some cases.
Diagnosing sick sinus syndrome
Sick sinus syndrome is diagnosed using:
- Electrocardiogram (ECG or EKG) to assess heart rhythms and identify abnormal patterns.
- Holter monitor, which records the heart’s activity over 24-48 hours to capture irregular rhythms.
- Blood tests to check for underlying conditions, such as thyroid problems or electrolyte imbalances.
- Echocardiogram to evaluate heart structure and rule out other potential causes of symptoms.
Treatment of sick sinus syndrome
Treatment for sick sinus syndrome depends on the severity of symptoms and may include:
- A pacemaker implantation, which helps regulate the heart rate and prevent episodes of bradycardia.
- Medications to control any underlying heart conditions, like thyroid hormone replacement for hypothyroidism.
- Adjustments to medications that may be contributing to the condition, like reducing beta-blocker use.
- In some cases, antiarrhythmic medications may be prescribed to manage episodes of tachycardia.