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Sick sinus syndrome(SSS): Causes-Symptoms-Diagnosis-Treatment


 What Is Sick Sinus Syndrome(SSS)?

Sick sinus syndrome (SSS) is an ailment wherein the coronary heart's natural pacemaker located inside the higher proper coronary heart chamber (right atrium) turns into damaged and is no longer able to generate ordinary heartbeats at the normal fee. It can be a result of different clinical conditions that harm the sinoatrial node (SA node) over time or may be a result of certain drugs. This can bring about heartbeats which might be too sluggish, too fast ⁠— or heartbeats that change between sluggish and rapid. 

What Is Sick Sinus Syndrome(SSS)?
Sick Sinus Syndrome

Sick sinus syndrome (SSS) is a circumstance that gives you a strange heartbeat. It happens when your heart's herbal pacemaker, the sinus node, no longer functions efficiently. This affects odd heart rhythms.

Sick sinus syndrome may be the result of many various things. These include the growing older manner, positive medicines, coronary heart sickness, or other situations.

  1. Circulatory system

Medical terms

  • The sinus cavities are hollow spaces located on both sides of the nose behind the eyes and above the cheeks They connect to a mucous membrane that lines the mouth throat and nasal passages The sinuses help produce mucus in order to moisten and cleanse these areas The body uses this mucus to trap bacteria and viruses that enter the body It also helps to humidify inhaled air during breathing.

  • Sinusitis is a common condition characterized by inflammation of the sinus cavities which are air-filled spaces in the skull that serve as passageways to the nose and lungs The inflammation can be caused by an infection or a reaction to an irritant such as cigarette smoke allergies or air pollution Sinusitis may also occur after viral infections such as influenza.

  • Sick sinus syndrome is a type of heart rhythm disorder. It impacts the coronary heart's natural pacemaker (sinus node), which controls the heartbeat. Sick sinus syndrome causes gradual heartbeats, pauses (long durations among heartbeats) or abnormal heartbeats (arrhythmias).

  • Sick sinus syndrome is enormously uncommon. The chance of developing it will increase with age. Many humans with unwell sinus syndrome sooner or later need an implanted device known as a pacemaker to keep the heart in an everyday rhythm.

  • Sick sinus syndrome may also be referred to as sinus node dysfunction or sinus node ailment.

  • Sick sinus syndrome, also known as sinus node disorder, is a disease of the sinoatrial node caused by impaired pacemaker feature and impulse transmission producing a constellation of peculiar rhythms. These include atrial bradyarrhythmias, atrial tachyarrhythmias and, on occasion, bradycardia alternates with tachycardia frequently known as tachy-brady syndrome. These arrhythmias may also bring about palpitations and decreased tissue perfusion and consequent fatigue, lightheadedness, presyncope, and syncope. This pastime describes the pathophysiology, assessment, and management of sick sinus syndrome and highlights the position of the interprofessional team in its management.

Types Sick sinus syndrome

Sick sinus syndrome can encompass exceptional kinds of coronary heart rhythm problems which includes arrhythmias.There are a couple of problems that occur whilst the sinus node doesn’t paint nicely. The ensuing heart beat or rhythm may be specific, relying on the specific electrical pastime on the sinus node.

The issues that characterize SSS encompass:

  • sinus bradycardia: the heart beats very slowly, less than 60 beats per minute

  • sinus arrest or sinus pause: The sinus node temporarily stops operating or pauses, causing a change within the heart’s beating

  • sinoatrial block: The sinus node impulse is blocked from achieving the atria, the 2 upper chambers of the heart

  • tachycardia-bradycardia (or tachy-brady) syndrome: The heart alternates between a completely gradual and really fast beat

Symptoms Sick sinus syndrome

It may be hard to recognise when you have sick sinus syndrome. Most people will no longer display any signs and symptoms. Your signs can also be too weak to note. When they do occur, Most people with unwell sinus syndrome have few or no signs. Symptoms can be slight or come and pass — making them hard to understand in the beginning.

Signs and signs and symptoms of unwell sinus syndrome might also consist of:

  • A sensation of rapid, fluttering heartbeats (palpitations)

  • Chest pain or discomfort

  • Confusion

  • Dizziness or lightheadedness

  • Fainting or near fainting

  • Fatigue

  • Shortness of breath

  • Slower pulse (bradycardia)

When to see a doctor

Talk to your fitness care issuer if you have any signs and symptoms or signs and symptoms of unwell sinus syndrome. Many scientific situations can cause these problems. It's important to get a timely and accurate analysis.

If you have new or unexplained chest pain or suppose you are having a heart attack, name for emergency scientific help right now.

Causes Sick sinus syndrome

Sick sinus syndrome most customarily happens in humans older than age 50. It is regularly because of scar-like damage to electrical pathways in the coronary heart muscle groups.

In kids, coronary heart surgical treatment on the upper chambers is a not unusual motive of unwell sinus syndrome.

Coronary coronary heart sickness, excessive blood strain, and aortic and mitral valve illnesses can also occur with sick sinus syndrome. However, those illnesses may additionally have nothing to do with the syndrome.

Sick sinus syndrome is uncommon, however no longer uncommon. It is the maximum common cause humans want to have a synthetic pacemaker implanted. Sinus bradycardia takes place more often than the other kinds of the situation.

Tachycardias (fast coronary heart rhythms) that begin within the top chambers of the coronary heart can be part of the syndrome. These consist of atrial traumatic inflammation, atrial flutter, atrial tachycardia. A duration of speedy coronary heart fees is frequently accompanied with the aid of very slow coronary heart charges. When there are periods of both slow and fast coronary heart prices (rhythms) the condition frequently may be referred to as tachy-brady syndrome.

Some medicines can make atypical coronary heart rhythms worse, especially when doses are high. These consist of digitalis, calcium channel blockers, beta-blockers, and antiarrhythmics.

To understand the reason for ill sinus syndrome, it is helpful to recognise how the heart commonly beats.

The coronary heart is made from 4 chambers — two top (atria) and two lower (ventricles). The rhythm of the coronary heart is commonly managed via the sinus node, an area of specialized cells within the proper upper heart chamber (proper atrium).

This natural pacemaker produces electrical signals that trigger every heartbeat. From the sinus node, electric indicators tour throughout the atria to the ventricles, inflicting them to settle and pump blood to the lungs and frame.

Typically, the sinus node creates a consistent tempo of electrical impulses. The pace modifications rely on activity, feelings and different factors.

In unwell sinus syndrome, the electrical signals are irregularly spaced. The heartbeat can be too speedy, too sluggish, interrupted by lengthy pauses — or an alternating combination of these rhythm troubles. Sick sinus syndrome is pretty uncommon, but the risk of developing it increases with age.

Causes of ill sinus node syndrome can consist of:

  • Age-related wear and tear of heart tissues

  • Damage to the sinus node or scarring from heart surgery

  • Heart disease

  • Inflammatory diseases affecting the heart

  • Medications to treat high blood pressure, including calcium channel blockers and beta blockers

  • Medications to treat irregular heartbeats (arrhythmias)

  • Some Alzheimer's disease medications

  • Neuromuscular diseases, such as muscular dystrophy

  • Obstructive sleep apnea

  • Rare genetic changes

Features of sick sinus syndrome include:

  • Sinus bradycardia. The sinus node produces a slow heartbeat.

  • Sinus arrest. Signals from the sinus node pause, causing skipped beats.

  • Sinoatrial exit block. Signals to the higher coronary heart chambers are slowed or blocked, causing pauses or skipped beats.

  • Chronotropic incompetence. The heart fee is inside regular variety at rest however does not increase as tons because it has to with physical interest.

  • Tachycardia-bradycardia syndrome. The coronary heart price alternates between unusually gradual and speedy rhythms, frequently with a long pause between heartbeats.

Risk factors Sick sinus syndrome

Sick sinus syndrome impacts men and women similarly, and can occur at any age. But most cases of SSS arise in humans over age 70, due to the fact growing older tends to sluggish the heart rate and lower SA node feature.

Sick sinus syndrome can occur at any age. It's most common in humans of their 70s or older. Common heart ailment chance factors might boost the hazard of sick sinus syndrome. Risk factors for coronary heart sickness encompass:

  • High blood pressure

  • High cholesterol

  • Excess body weight

  • Lack of exercise

Complications Sick sinus syndrome

Sick sinus syndrome often progresses over time. When your coronary heart beats too slowly, or too speedy,Complications of unwell sinus syndrome include:

  • Atrial fibrillation, a type of irregular heartbeat (arrhythmia)

  • Heart failure

  • Stroke

  • Cardiac arrest

What drugs are used to treat sick sinus syndrome?

Sick sinus syndrome is a fairly common disorder that occurs when the heart's electrical system malfunctions and causes the heart to beat too slowly There are a number of drugs and other treatments that can help treat sick sinus syndrome including beta blockers which slow down and strengthen the heartbeat as well as digitalis and amiodarone which speed up and strengthen the heartbeat A pacemaker may also be an effective treatment for the condition.

Does sick sinus syndrome need treatment?

While many heart conditions do not require treatment the symptoms of sick sinus syndrome can be severe enough to impair quality of life In addition if they occur during exercise or other physical activity they can be dangerous Treatments for sick sinus syndrome aim to control its symptoms and reduce the risk of complications and life-threatening events.

Can you reverse sick sinus syndrome?

People with sick sinus syndrome have a slow heart rate which causes blood to accumulate in the body's veins The heart's two upper chambers (the atria) don't fully contract and squeeze blood into the lower chamber (the ventricle) which then pumps blood to the lungs and other parts of the body This accumulation of blood in the veins leads to swelling of the legs feet and ankles It also puts pressure on the right side of the heart potentially leading to problems such as an irregular heartbeat or blood clots The disease can be treated with medications or surgery.

What triggers sick sinus syndrome?

It's unclear what causes sick sinus syndrome but it is thought to be a problem with the heart's pacemaker which regulates the heart rate The first signal that something is wrong occurs when the heart temporarily slows down by 10 to 20 beats per minute This pause lasts for only a few seconds Then the heart speeds up beating faster than usual for about a minute This rapid heartbeat is called tachycardia Sick sinus syndrome often progresses to complete heart block which means that the upper chambers of the heart no longer respond to electrical signals from the pacemaker As a result this chamber doesn't beat at all and blood cannot flow freely between your heart's lower chambers which can cause dizz.

Does sick sinus syndrome shorten your life?

Sick sinus syndrome is a problem with the autonomic nervous system that controls heart rate blood pressure and rhythm In this condition instead of receiving a normal signal from the heart’s pacemaker known as the sinoatrial node (SA node) the heart’s lower chambers receive an abnormal signal This leads to a lack of coordination between the atria and ventricles which makes it difficult for blood to get pumped out of the heart It’s possible to be born with sick sinus syndrome or develop it later in life due to damage to the SA node caused by other health problems The most common symptoms are fainting and dizziness especially when you stand up after sitting.

Does a pacemaker resolve sick sinus syndrome?

The sick sinus syndrome is a cardiac disorder that can be caused by an abnormality in the electrical activity of the heart It occurs when there is abnormal paced rhythm due to aberrant signals The abnormal signal leads the atria to contract before the ventricles leading to a slow heart rate When this rhythm is present it can lead to symptoms such as dizziness fainting and fatigue This can also affect people who have pacemakers or are taking medications that change the way their heart beats.

Diagnosis Sick sinus syndrome

Your healthcare provider will probably order checks to rule out different conditions if they believe you have unwell sinus syndrome. SSS can appear a lot like many other illnesses.

To make the prognosis, your physician or cardiologist will carry out the subsequent tests.

To diagnose ill sinus syndrome, a health care company performs a bodily examination and asks approximately for symptoms and clinical records.

Symptoms of sick sinus syndrome — together with dizziness, shortness of breath and fainting — most effectively occur while the coronary heart is beating irregularly. You might not have symptoms at the time of the appointment.

To determine whether signs are associated with issues with the sinus node and heart characteristic, a health care issuer might also use the subsequent checks:

  • Electrocardiogram (ECG or EKG). This simple test measures the electric pastime of the heart. Sensors (electrodes) are connected to the chest and legs. Wires connect the sensors to a laptop, which displays or prints results. An ECG can tell how speedy or slow the coronary heart is beating. A health care provider can look for signal styles to determine if unwell sinus syndrome is a gift.

  • Holter monitor. This transportable ECG tool may be worn for a day or more at some stage in everyday activities. It mechanically informs the coronary heart's pastime for 24 to seventy two hours. An individual sporting a monitor may preserve a diary of signs and symptoms.

  • Event recorder. This transportable ECG device is supposed to be worn for up to 30 days or until you've got an abnormal heartbeat or signs. You usually press a button whilst symptoms occur.

  • Other monitors. Some non-public gadgets, along with clever watches, provide electrocardiogram monitoring. Ask your fitness care company if that is an option for you.

  • Implantable loop recorder. This small ECG device is implanted simply below the skin of the chest. It's used for continuous, lengthy-time period tracking of the coronary heart's electric interest, particularly for humans who have rare signs and symptoms.

Electrophysiologic (EP) testing

This check, also known as an EP examine, is hardly ever used to display screens for sick sinus syndrome. However, it can be accomplished to test the function of the sinus node and to evaluate other electric homes of the heart.

During an EP look at, thin, bendy wires tipped with electrodes are threaded through blood vessels to exclusive regions inside the heart. Once in place, the electrodes can map the unfold of electrical alerts via the heart.

Treatment Sick sinus syndrome

Treatment for slight or early instances of SSS entails relieving signs. Your docs might also modify or change your medicine if that’s the trouble. They may additionally prescribe extra medicines that may have an immediate impact on heart rhythm.

Eventually, however, the general public with SSS will need an synthetic pacemaker implant whilst the sinus node is no longer capable of correctly performing.

A pacemaker is a very small system that’s surgically and subcutaneously implanted within the chest or stomach to regulate your heartbeat. It does this by means of sending electrical pulses to the coronary heart.

Almost one-halfTrusted Source of pacemaker implantations are performed because of issues related to unwell sinus syndrome. Pacemakers are commonly tolerated properly, and the majority experience few headaches.

The dreams of an unwell sinus remedy are to reduce or eliminate symptoms and to control every other contributing fitness condition.

Treatment of unwell sinus syndrome may also encompass:

  • Regular checkups

  • Medications

  • Catheter procedures

  • Surgery to implant a device to maintain a regular heartbeat (pacemaker)

If you don't have signs, your health care provider may additionally genuinely advocate normal health checkups to screen your situation. Most humans with signs and symptoms need to have a procedure to implant a device to preserve a regular heartbeat (pacemaker).


Some medicines, inclusive of those used to treat high blood strain or coronary heart ailment, may additionally interfere with sinus node function. Your health care company will probably assess the medicinal drugs you take and can modify them or prescribe one of a kind ones.

Medications may be had to prevent or to slow down speedy heartbeats.

Blood-thinners (anticoagulants), which includes warfarin (Jantoven), dabigatran (Pradaxa) or others, can be prescribed if ill sinus syndrome is associated with atrial fibrillation or other abnormal heart rhythms linked to stroke.

Surgeries or other procedures

Most people with ill sinus syndrome sooner or later want an everlasting device to manipulate the coronary heart rhythm (pacemaker). A pacemaker is a small, battery-powered device that is implanted beneath the skin close to the collarbone at some point of a minor surgical operation. The pacemaker stimulates (paces) the coronary heart as needed to preserve it beating often.

If unwell sinus syndrome signs are mild or rare, the choice to apply a pacemaker will depend on the results of electrocardiograms (ECGs), your usual health and the hazard of more-critical troubles.

The form of pacemaker you want relies upon the kind of irregular heart rhythm you have. Types of pacemakers include:

  • Single chamber pacemaker. This kind commonly carries electrical signals to the proper decreased coronary heart chamber (ventricle) of the coronary heart.

  • Dual chamber pacemaker. This type paces the right lower heart chamber (ventricle) and the proper top heart chamber (atrium) separately. Most human beings with sick sinus syndrome gain from twin-chamber pacemakers.

  • Biventricular pacemaker. Biventricular pacing, also referred to as cardiac resynchronization remedy, is for humans who have heart failure and heartbeat issues. This type of pacemaker stimulates both decreased coronary heart chambers (the right and left ventricles) to make the heart beat extra efficiently.

If your heart fee is still abnormal after getting a pacemaker, you may want medications or a catheter-based total manner known as cardiac ablation to accurately or manipulate it. Cardiac ablation uses warmness or bloodless energy to create tiny scars inside the coronary heart to block faulty alerts and repair an everyday heartbeat. It most usually accomplished the usage of skinny, flexible tubes referred to as catheters inserted through the veins or arteries. Less generally, ablation is executed all through cardiac surgery. A kind of cardiac ablation known as AV node ablation is often used to govern rapid heart rhythms in people with pacemakers.

  1. Cardiac rehabilitation and circulatory rehabilitation

Lifestyle and home remedies

It's critical to take steps to lower the danger of heart disorder. Try these coronary heart-healthy strategies:

  • Eat a healthy diet. Choose beneficent quantities of non starchy greens, fruits and entire grains and modest portions of fish, lean meats, rooster and dairy.

  • Exercise and maintain a healthy weight. Being overweight will increase the hazard of growing coronary heart sickness. Unless your company tells you in any other case, intention for at least half-hour of moderate bodily interest every day. Ask your fitness care company what your intention weight should be.

  • Keep blood pressure and cholesterol under control. Make lifestyle modifications and take medicinal drugs as prescribed to manipulate high blood stress or excessive ldl cholesterol.

  • Don't smoke. If you smoke and can't end it on your own, communicate with your fitness care issuer about ways or programs to help spoil a smoking habit.

  • If you drink, do so in moderation. For a few conditions it is encouraged that you completely keep away from alcohol. Ask your fitness care issuer for recommendations specific for your circumstance. If you cannot control your alcohol use, talk to your company about a software to end ingesting and manipulate other behaviors associated with alcohol use.

  • Don't use illegal drugs. Talk to your provider about a program if you need help quitting.

  • Control stress. Getting more workout, working towards mindfulness and connecting with others in support companies are some approaches to reduce strain.

  • Go to scheduled checkups. Have normal bodily assessments and report any symptoms or symptoms for your fitness care provider.

Preparing for your appointment

Call your healthcare provider when you have symptoms of unwell sinus syndrome. You are probably referred to a health practitioner trained in diagnosing and treating heart conditions (heart specialist).

Be organized to answer questions about your medical history and symptoms. Write down your answers that will help you remember information.

Questions your company may additionally ask about signs and symptoms encompass:

  • Do your symptoms include feeling lightheaded or dizzy?

  • Have you ever fainted?

  • Do you have rapid, fluttering or pounding heartbeats?

  • Do you feel pressure, heaviness, tightness or pain in your chest?

  • Does exercise or activity worsen your symptoms?

  • Does anything improve your symptoms?

  • How often have you had symptoms?

  • How long have the symptoms lasted?

Other questions may include the following:

  • Have you been diagnosed with high blood pressure, high cholesterol, diabetes or a heart condition?

  • What medications do you take and what dosage? Who is the prescribing doctor?

  • Why were the prescription drugs prescribed?

  • Have you been taking the medication as prescribed?

  • Have you recently stopped, started or changed medications?

  • What over-the-counter medications, herbal remedies or supplements do you take?

Write down any questions you have in your issuer. You may deliver a chum or relative to jot down down data at some point of the appointment.

What you can do in the meantime

If exercise makes your symptoms worse, avoid exercising till you notice your company.

General summary

  1. Sick sinus syndrome is a group of symptoms that can occur when the heart's natural pacemaker which is in the right upper chamber of the heart (right atrium) malfunctions The condition may be caused by damage to the heart's electrical wiring system (cardiac conduction system) or by problems in the right atrium itself This article will help you learn more about sick sinus syndrome and its possible treatments.

Sick sinus syndrome(SSS): Causes-Symptoms-Diagnosis-Treatment

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