What is Sick Sinus Syndrome

Sick sinus syndrome is a group of conditions that affect heart rhythm and how quickly the heart beats (heart rate). When you have sick sinus syndrome, your heart rate may be too fast (tachycardia) or too slow (bradycardia), or it may switch between fast and slow.

What are the causes?

Your heartbeat is controlled by a structure in the heart called the sinoatrial (SA) node. Sick sinus syndrome happens when the SA node does not work properly (SA node dysfunction). It is not known what causes this.

What increases the risk?

This syndrome is more likely to develop in people who:

• Are age 65 or older.
• Have a family history of the syndrome.
• Have had a heart attack or heart surgery.
• Have sleep apnea.
• Have coronary artery disease.
• Have inflammation of the heart muscle (myocarditis) or the sac that surrounds the heart (pericarditis).
• Use medicines such as beta blockers, some calcium channel blockers, or digoxin.
• Have an abnormal level of thyroid hormone or electrolytes.
• Have high blood pressure (hypertension).
• Have had infections that affect the heart, like rheumatic fever or diphtheria.
• Are born with heart defects (congenital heart disease).

What are the signs or symptoms?

Symptom of this syndrome include:

• Fainting or feeling like you are going to faint.
• Chest pain.
• Shortness of breath.
• Dizziness.
• Feeling like your heart skips beats.
• Feeling like your heart beats very quickly.
• Tiredness.
• Fatigue.
• Confusion.

Some people with this condition do not have any symptoms. Most people have few symptoms or very mild symptoms.

How is this diagnosed?

This syndrome may be diagnosed with tests, such as:

• A test that measures electrical activity in the heart (electrocardiogram, or ECG).
• A test in which you wear a device called a Holter monitor for 1–2 days. The device will record your heart’s electrical signals.
• Placing a device to record the electrical activity of your heart over a longer period of time (implantable loop recorder).
• An test to look at the electrical system of your heart (electrophysiology study).
• Blood tests.

How is this treated?

Treatment for this syndrome may include:

• Surgery to put a small, electrical device in your chest to correct your heartbeat (pacemaker).
• Medicines to keep your heart from beating too quickly.
• Stopping taking certain medicines as told by your health care provider.
• Treatment of the underlying condition.

If the syndrome is not causing any symptoms, you may not need treatment.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Stay active and stay at a healthy weight. Ask your health care provider what level of activity is safe for you.
• Eat a heart-healthy diet that includes fruits, vegetables, whole grains, low-fat dairy products, and lean proteins like poultry and eggs. Ask your health care provider if you should:
  • Avoid any foods or drinks.
  • Limit your salt (sodium) intake.
• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a cough that does not go away.
• You have swelling in your feet or ankles.
• You feel short of breath with activity.
• You feel fatigued.

Get help right away if:

• You have chest pain or difficulty breathing.
• You suddenly have weakness, numbness, or loss of movement on one side of your body.
• You suddenly become very confused.
• You suddenly lose the ability to speak or understand speech.
• You feel like your heart is skipping beats.
• You feel like your heart is beating very quickly.
• You faint or feel like you are going to faint.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• When you have sick sinus syndrome, your heart rate may be too fast (tachycardia) or too slow (bradycardia), or it may switch between fast and slow.
• Treatment for this syndrome may include taking medicines and having a pacemaker placed in your chest.
• If you have chest pain or difficulty breathing, get help right away. Do not drive yourself to the hospital.