A Family Doctor's Tale -BRADYCARDIA

DOC I HAVE BRADYCARDIA

Bradycardia is a symptom defined as heart rate below 55 per minute.

Causes of Bradycardia:
1.Bradycardia can occur normally in athletes as a result of training through increased cardiac vagal tone.

2.Abnormalities of the heart conducting system:
a.complete heart block

b.ischemic heart disease

c.congeital heart disease

3.Underlying systemic disease:
a.myxedema

b.increased intracranial disease

4.Medicines:
a.Beta blockers

b.digoxin overdosage

c.reserpine

Symptoms:
1.slow pulse at wrist

2.confirmation with ECG

3.fainting

4.asymptomatic in many cases

Treatment of bradycardia:
1. None if no symptoms and no underlying cause

2. Cardiac bradycardia from heart block may be treated with atropine

3.Sympathommetics such as isoproterenol may be given as temporary measure before treatment of underlying conditions or insertion of pacemaker

4. Treat underlying conditions such as myxedema

5. heart blocks or asystole may need pacemaker implantation

Prognosis:
1.depends on underlying cause -myxedema is less serious than intracranial pressure

2.Patient receiving pacemakers often have an excellent long term survival