Syndrome of weakness of the sinus node

Sinus node dysfunction syndrome is a pathology of rhythm that appears due to the loss or weakening of the function of the automatic operation of the sinus-atrial node. With this syndrome, there is a disruption in the conduct and formation of a pulse into the atrium from the sinus node, which externally manifests itself in the fall of the heart rhythm and its reduction( bradycardia), and also through ectopic arrhythmias. In patients who have this syndrome, there is a high probability of sudden cardiac arrest.

Symptoms of weakness syndrome sinus node

There are many different options for the course of the syndrome. In some patients, the clinical symptoms of SSSU may be absent for a long period of time, others show vivid rhythm disturbances, which in especially severe cases may be accompanied by dizziness, headaches, attacks of Morgagni-Adams-Stokes. Hemodynamic disorder due to a decrease in the minute and shock volume of the ejection, which is also accompanied by the development of edema of cardiac asthma, coronary insufficiency( in rare cases - myocardial infarction, a little more often - angina).

In the SSSU clinic specialists distinguish two main categories of symptoms - cardiac and cerebral.

Among cerebral symptoms, especially if the rhythm disturbances are poorly expressed, one can observe irritability, emotional lability, fatigue, forgetfulness. In the elderly, intellect and memory decrease.

If the syndrome progresses and the brain lacks blood circulation, then the cerebral symptoms grow and multiply. There are fainting and pre-fainting conditions, in which there are such symptoms as tinnitus, a feeling of interruptions in the activity of the heart or its stoppage, a sharp weakness. Fainting of the cardiac type, observed in the Morgagni-Edessa-Stokes syndrome, can occur without these signs and seizures( the exception is the case of prolonged asystole).

Cardiac symptoms in the syndrome are manifested in the form of sensations to patients with irregular or severely retarded heartbeat, pain behind the sternum, appearing due to a lack of coronary blood flow. Later there are arrhythmias, which are accompanied by irregularities in the heart, palpitations, weakness, dyspnea, the appearance of heart failure of a chronic nature.

With the development of the syndrome, it is often possible to observe the attachment of fibrillation or a ventricular tachycardia, which significantly increases the risk of developing cardiac sudden death.

Other manifestations of SSSU include abnormalities in the work of the gastrointestinal tract, oliguria, which arises due to renal hypoperfusion, intermittent claudication, weakness in the muscles, which appears due to insufficient supply of muscles and internal organs with oxygen.

Treatment of SSSU

The volume of therapeutic therapy for a given syndrome depends on many parameters: the severity of the pathology of the rhythm, the severity of clinical symptoms, the extent to which conductivity, etiology, etc. are violated.

If the symptoms of SSSU are absent or expressed minimally, then the treatment of the underlying disease is performed, in which the patient is dynamically observed at the cardiologist.

Medication-based treatment can be prescribed for mild manifestations of tachy- and bradyarrhythmias, but it is ineffective.

One of the main ways to treat SSSU is permanent electrocardiostimulation. If the SSSU clinic, caused by bradycardia, is expressed clearly and there are signs of cardiac failure of a chronic nature, then an implantation of the pacemaker is made, which works in the "on demand" mode, that is, it starts to generate pulses when the heart rate drops to a certain level.

Absolute indications for the appointment of pacing are:

  • VVFSU more than 3 seconds with bradycardia less than forty beats per minute;
  • Combination of bradycardia with various types of arrhythmias, which require therapy with anti-antimortic drugs, which is unacceptable with impaired conductivity;
  • At least a single occurrence of the attack of Morgagni-Edessa-Stokes;
  • Presyncopal conditions, dizziness, high arterial hypertension, coronary insufficiency.