47. Sick sinus syndrome

หญิง 76 ปี underlying DM, HT, CRF, DLP เหนื่อย ใจสั่น วูบ ขณะยืนอยู่, Monitor EKG เป็นดังนี้ ถาม Dx, Rx


เพิ่มเติม : EKG ที่เห็นยังไม่ได้ Rx. อะไรเลยนะครับ

Sick sinus syndrome [Tachycardia-bradycardia syndrome]

•Sick sinus syndrome, uncommon syndrome. This arrhythmias including sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia (slow heart rate).
•Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation. pause after the tachycardia

Treatment

-Pacemakers have been used in the treatment of sick sinus syndrome.
-Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy.
-However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.