SignSymptom infobox Name Bradycardia Image Sinusbradylead2.JPG Caption Sinus bradycardia seen in lead ... , ICD9 785.9 , ICD9 779.81 ICDO OMIM MedlinePlus eMedicineSubj eMedicineTopic MeshID D001919 Bradycardia ... drops below 50 beat min. It may cause cardiac arrest in some patients, because those with bradycardia ... of breath, and if severe enough, death. ref name SINUS BRADYCARDIA http www.emedicine.com emerg topic534.htm Sinus Bradycardia eMedicine ref Trained sportsperson athlete s or young healthy individuals ... rate of 28 beats per minute . ref L quipe, France, 2 July 2004 ref Resting bradycardia is often ... relative bradycardia is used in explaining a heart rate which although not actually below 60 ... Bradycardia in an adult is any heart rate less than 60 beats per minute, although symptoms ... also Sinus bradycardia Sick sinus syndrome Atrial bradycardias come in three different types. The first ... If the decrease during exhalation drops the heart rate below 60bpm on each breath, this type of bradycardia is usually deemed benign and a sign of good autonomic tone. Sinus bradycardia is a sinus rhythm ... of conditioned athletes have benign sinus bradycardia, as compared to 23 percent of the general ... conditions that include severe sinus bradycardia, sinoatrial block, sinus arrest, and bradycardi tachycardia ... HN Atrioventricular nodal See also Junctional rhythm An atrioventricular nodal bradycardia or AV junction ... vagal tone on the SA node. Pathological causes include sinus bradycardia, sinus arrest, sinus exit block, or AV block. ref name HN Ventricular See also Atrioventricular block A ventricular bradycardia ... Ventricular bradycardias occurs with sinus bradycardia, sinus arrest, and AV block. Treatment often consist of the administration of atropine and cardiac pacing. ref name HN Infantile For infants, bradycardia ... per minute. Premature babies are more likely than full term babies to have apnea and bradycardia ... particular bradycardia, but the underlying mechanism is not clinically relevant to treatment, which ... more details
SignSymptom infobox Name Sinus bradycardia Image Sinusbradylead2.JPG Caption Sinus bradycardia seen in lead II with a heart rate of about 50. ICD10 ICD9 ICD9 427.81 MeshID D001146 Unreferenced date August 2009 Sinus bradycardia is a heart rhythm that originates from the sinus node and has a rate of under 60 beats per minute . Signs and symptoms The decreased heart rate can cause a decreased cardiac output resulting in symptoms such as lightheadedness , dizziness , hypotension , Vertigo medical vertigo , and Syncope medicine syncope . The slow heart rate may also lead to atrial , junctional, or Ventricle heart ventricular ectopic rhythms. Bradycardia is not necessarily problematic. People who regularly practice sports may have sinus bradycardia, because their trained hearts can pump enough blood in each contraction to allow a low resting heart rate . Sinus Bradycardia can aid in the sport of Freediving , which includes any of various aquatic activities that share the practice of breath hold underwater diving. Citation needed date August 2009 Bradycardia aids in this process due to drop in blood rate pulse. Citation needed date August 2009 These adaptations enable the human body to endure depth and lack of oxygen far beyond what would be possible without the mammalian diving reflex . Citation needed date August 2009 Sinus bradycardia is a sinus rhythm of less than 60 bpm. It is a common condition found in both healthy individuals and those who are considered well conditioned athletes. Studies have found that 50 85 percent of conditioned athletes have benign sinus bradycardia, as compared to 23 percent of the general population studied. Trained athletes or young healthy individuals may also have a slow resting heart rate. Cause This rhythm may be caused by one of the following Increased vagal Muscle tone tone . Sleep Hypothermia Hypothyroidism Intrinsic disease of the SA ... DEFAULTSORT Sinus Bradycardia Category Cardiac dysrhythmia nl Sinusbradycardie sv Sinusbradykardi ... more details
Reflex bradycardia is a bradycardia decrease in heart rate in response to the baroreceptor reflex , one of the body s homeostatic mechanisms for preventing abnormal increases blood pressure . In the presence of high mean arterial pressure , the baroreceptor reflex produces a reflex bradycardia as a method of decreasing blood pressure by decreasing cardiac output . Blood Pressure BP is determined by cardiac output CO and total peripheral resistance TPR , as represented by the formula BP CO x TPR. Cardiac output CO is affected by two factors, the heart rate HR and the stroke volume SV , the volume of blood pumped from one Ventricle heart ventricle of the heart with each beat CO HR x SV, therefore BP HR x SV x TPR . In reflex bradycardia, blood pressure is reduced by decreasing cardiac output CO via a decrease in heart rate HR . An increase in blood pressure can be caused by increased cardiac output, increased total peripheral resistance, or both. The baroreceptor s in the carotid sinus sense this increase in blood pressure and relay the information to the cardiovascular centre s in the brainstem . In order to maintain homeostasis , the cardiovascular centres activate the parasympathetic nervous system . Via the vagus nerve , the parasympathetic nervous system stimulates neurons that release the neurotransmitter acetylcholine ACh at synapses with cardiomyocyte cardiac muscle cells . Acetylcholine then binds to Muscarinic acetylcholine receptor M2 M sub 2 sub muscarinic receptors , causing the decrease in heart rate that is referred to as reflex bradycardia. The M sub 2 sub muscarinic receptors decrease the heart rate by inhibiting depolarization of the sinoatrial node via Gi alpha subunit G sub i sub protein G protein coupled receptor coupled receptors and through modulation ... title Reflex bradycardia during surgery journal Canadian Journal of Anesthesia volume 37 issue 2 pages 219 222 doi 10.1007 BF03005473 ref Stimuli causing reflex bradycardia include Oculocardiac reflex ... more details
Transcutaneous pacing also called external pacing is a temporary means of pacing a patient s heart during a medical emergency. It is accomplished by delivering pulses of electric current through the patient s chest, which stimulates the heart to contract. The most common indication medicine indication for transcutaneous pacing is an abnormally slow heart rate . By convention, a heart rate of less than 60 beats per minute in the adult patient is called bradycardia . Not all instances of bradycardia require medical treatment. Normal heart rate varies substantially between individuals, and many athletes in particular have a relatively slow resting heart rate. In addition, the heart rate is known to naturally slow with age. It is only when bradycardia presents with signs and symptoms of Shock circulatory shock that it requires emergency medicine emergency treatment with transcutaneous pacing. Some common causes of hemodynamics hemodynamically significant bradycardia include acute myocardial infarction , sick sinus syndrome sinus node dysfunction and complete heart block . Transcutaneous pacing is no longer indicated for the treatment of asystole cardiac arrest associated with a flat line on the electrocardiogram ECG , with the possible exception of witnessed asystole as in the case of bifascicular block that progresses to third degree heart block complete heart block without an escape rhythm . During transcutaneous pacing, pads are placed on the patient s chest, either in the anterior lateral position or the anterior posterior position. The anterior posterior position is preferred as it minimizes transthoracic electrical impedance by sandwiching the heart between the two pads. The pads are then attached to a monitor defibrillator, a heart rate is selected, and current measured in milliamps is increased until electrical capture characterized by a wide QRS complex with tall, broad T wave on the electrocardiogram ECG is obtained, with a corresponding pulse. Pacing artifact ... more details
Sneezing powder refers to a group of Powder substance powders or powder like substances that induce sneezing when someone is exposed to them. This is usually done as a Practical joke device practical joke or prank to an unsuspecting victim. Sneezing powders containing Veratrum album alkaloid s have been linked to poisoning, including dyspepsia , fainting , bradycardia and hypotension . ref name carlier Carlier P, Efthymiou ML, Garnier R, Hoffelt J, Fournier E. Poisoning with Veratrum containing sneezing powders. Hum Toxicol. 1983 Apr 2 2 321 5. ref Children are especially vulnerable. ref name fogh Fogh A, Kulling P, Wickstrom E. Veratrum alkaloids in sneezing powder a potential danger. J Toxicol Clin Toxicol. 1983 Apr 20 2 175 9. ref See also Itching powder References reflist culture stub comedy stub Category Sneeze Category Practical joke devices de Niespulver ... more details
Liebermeister s rule concerns the increment ratio between and adult individual s cardiac frequency and temperature when in fever. Each Celsius grade of Thermoregulation body temperature increment corresponds to an 8 beats per minute in cardiac frequency. ref cite web url http www.whonamedit.com synd.cfm 3759.html title Liebermeister s rule publisher www.whonamedit.com date accessdate 2009 09 02 ref ref cite web url http www.mondofacto.com facts dictionary?Liebermeister 27s rule title mondofacto dictionary definition of Liebermeister s rule publisher Mondofacto.com date 2000 03 05 accessdate 2009 09 02 ref An exception to this rule by creating a relative bradycardia is known as Faget sign pulse temperature dissociation common in some diseases, especially yellow fever . It is named for Carl von Liebermeister . References reflist Eponymous medical signs for infectious disease Category Cardiology Category Medical signs Category Tropical diseases Category Viral diseases de Liebermeister Regel pl Prawo Liebermeistera ... more details
Orphan date October 2010 Unreferenced date October 2010 Vagotonia is the state of the autonomic nervous system in which the equilibrium between the sympathetic nervous system sympathetic and parasympathetic nervous system is biased towards the parasympathetic, the opposite phenomenon being sympatheticotonia . There is an associated clinical syndrome with low blood pressure hypotension , low heart rate bradycardia , miosis , often cold hands and feet and sometimes avolition . The parasympathetic nervous system is dominant in situations of rest and relaxation, it has an activating effect on digestive organs and a relieving one on the heart. Endurance training supports vagotonia. For example, a low heart rate may be observed with sportsmen. With trained people vagotonia isn t regarded as abnormal, but rather as beneficial and protective in effect. Category Parasympathetic nervous system med stub cs Vagotonie de Vagotonie it Vagotonia pl Wagotonia uk ... more details
Merge to Cushing reflex date May 2011 Cushing s triad is a clinical Triad anatomy triad variably defined as either hypertension, bradycardia, and irregular respiration ref name Mayer cite journal last Mayer first S.A. authorlink coauthors Chong, J.Y. title Critical care management of increased intracranial pressure journal Journal of intensive care medicine volume 17 issue 2 pages 55 67 publisher Wiley Online Library year 2002 url doi pmid ref , or less commonly as widened pulse pressure with elevated systolic and a either elevated or normal diastolic BP , irregular respiration, and bradycardia . ref name ayling cite journal last Ayling first J authorlink coauthors title Managing head injuries journal Emergency Medical Services volume 31 issue 8 pages 42 publisher year 2002 url doi pmid 12224233 ref It is sign medicine sign of increased intracranial pressure , and it occurs as a result of the Cushing reflex . It should not be confused with Cushing s syndrome , a disease state resulting from the elevated levels of blood cortisol . Significance Identification of the triad is important in emergency medicine because it suggests severe pressure within the cranial vault. This can be the result of cerebral hemorrhage , possibly due to a ruptured aneurysm or other stroke cerebrovascular accident a hemorrhagic stroke or head Physical trauma trauma resulting in concussion and associated intracranial bleeding either within or outside the meninges a subdural hematoma subdural or epidural hematoma epidural hemorrhage . It can also be due to an enlarging space occupying lesion a brain tumor . All of these events lead to the possibility of brain herniation , which can be rapidly Brain death fatal . Eponym It is named after Harvey Williams Cushing 1869 1939 , an United States American neurosurgeon . See also Cushing reflex Cheyne Stokes respiration References references External links http www.whonamedit.com synd.cfm 981.html Cushing triad whonamedit.com Category Neurosurgery Categ ... more details
Unreferenced date March 2009 A junctional escape beat is a delayed Cardiac cycle heartbeat originating not from the atrium anatomy atrium but from an Cardiac ectopy ectopic focus somewhere in the AV junction . It occurs when the rate of depolarization of the sinoatrial node falls below the rate of the atrioventricular node . This dysrhythmia also may occur when the electrical impulses from the SA node fail to reach the AV node because of SA or AV block. It is a protective mechanism for the heart, to compensate for the SA node no longer handling the pacemaking activity, and is one of a series of backup sites that can take over pacemaker function when the SA node fails to do so. Etiology A junctional escape complex is a normal response that may result from excessive vagal tone on the SA node, a pathological slowing of the SA discharge, or a complete AV block. ECG Characteristics Rate 40 60 bpm Rhythm Irregular in single junctional escape complex regular in junctional escape rhythm. P waves Depends on the site of the Cardiac ectopy ectopic focus. They will be inverted, and may appear before or after the QRS complex, or they may be absent, hidden by the QRS. P R interval If the P wave occurs before the QRS complex, the interval will be less than 0.12 seconds. QRS Complex Usually normal in duration and morphology, less than 0.12 seconds. Significance Junctional rhythms if a bradycardia , can cause decreased cardiac output. Therefore, the person may exhibit signs and symptoms similar to other bradycardia such as lightheadedness , dizziness , hypotension , and Syncope medicine syncope . Usually this rhythm can be tolerated if the rate is above 50 bpm. See also Ectopic beat Junctional rhythm Heart diseases DEFAULTSORT Junctional Escape Beat Category Cardiac dysrhythmia ... more details
Transvenous cardiac pacing , also called endocardial pacing , is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy. Transvenous pacing is achieved by threading a pacing electrode through a vein into the right atrium, right ventricle, or both. This means of pacing the heart is not as popular as other means of pacing see transcutaneous pacing , implanted pacemaker , epicardial pacing because it is a temporary solution to pace the heart and yet involves a similar level of risk of bleeding as a more permanent solution like placing an implanted pacemaker. For patients who present in an emergency setting with symptomatic bradycardias, usually drugs like atropine or sympathomimetic drugs e.g. epinephrine, dopamine, etc. can be used to increase the heart rate to an adequate level until the underlying cause of the bradycardia can be isolated and then, possibly, a permanent pacemaker can be placed. For patients for whom transvenous pacing is chosen, the procedure is done at the bedside with a local anesthetic alone or in conjunction with conscious sedation . The pacing electrode is advanced through the vein under flouroscopic and electrocardiographic guidance. An x ray after the procedure is always obtained to confirm placement of the pacing electrode. The greater use of atropine and epinephrine or external pacing may obviate the need for transvenous pacing by stabilizing patients early in the process of caring for the patient. Some debate exists over the efficacity and reliability of transvenous pacing, especially if the need for permanent pacing is anticipated. References Urden, L., Stacy, K., and Lough, M. Thelan s Critical Care Nursing Diagnosis and Management. Fourth Edition, Mosby, 1998. ISBN 0 323 01461 5 Handbook of Emergency Cardiovacular Care for Healthcare Providers. Editors Hazinski, M., Cummins, R., and Field, J. 20 ... more details
The Bezold Jarisch reflex involves a variety of cardiovascular and neurological processes which cause hypopnea overly shallow breathing or an abnormally low respiratory rate and bradycardia abnormally low resting heart rate . ref name pmid17567718 cite journal author Salo LM, Woods RL, Anderson CR, McAllen RM title Nonuniformity in the von Bezold Jarisch reflex journal Am. J. Physiol. Regul. Integr. Comp. Physiol. volume 293 issue 2 pages R714 20 year 2007 month August pmid 17567718 doi 10.1152 ajpregu.00099.2007 url http ajpregu.physiology.org cgi pmidlookup?view long&pmid 17567718 ref Physiology Prolonged upright posture results in some degree of pooling of blood in the lower extremities that can lead to diminished intracardiac volume. This phenomenon is accentuated if the individual is dehydrated. The resultant arterial hypotension is sensed in the carotid sinus baroreceptors , and efferent fibers from these receptors trigger autonomic signals that increase cardiac rate and contractility. However, pressure receptors in the wall and trabeculae of the underfilled left ventricle may then sense stimuli, indicating high pressure C fiber afferent nerves from these receptors. They may respond by sending signals that trigger paradoxical bradycardia and decreased contractility, resulting in additional and relatively sudden arterial hypotension . It usually occurs in nitrate therapy and use of serotonin agonists. ref http www.emedicine.com ped topic2188.htm eMedicine Syncope Article by M Silvana Horenstein, MD Bot generated title ref History It is named for Albert von Bezold and Adolf Jarisch Junior . ref WhoNamedIt synd 3165 ref References reflist Reflex Eponymous medical signs for circulatory and respiratory systems Category Cardiovascular diseases Category Reflexes med sign stub de Bezold Jarisch Reflex it Riflesso di Bezold Jarisch ... more details
include bradycardia , hypothermia , and tachypnea . Substances that may cause this toxidrome include ... is DUMBELLS Diarrhea, Urination, Miosis pinpoint pupils , Bradycardia slow heart rate , Emesis, Lacrimation .... Complications include bradycardia , hypotension , and hypothermia . Substances ... s. Complications include bradycardia , hypertension , and tachycardia . Substances that may cause ... more details
Micturition syncope or post micturition syncope is the name given to the human phenomenon of fainting shortly after or during urination . People often become pale, nauseated, sweaty and weak before they lose consciousness. Sometimes even defecating , cough ing or severe vomiting may cause fainting in a similar way. Epidemiology Responsible for 2.4 to 8.4 percent of all cases of fainting in adult s, it most commonly occurs in male s. The events often occur at night or after awaking this means that it occurs while standing immediately after being recumbent for some time . Causes When one strains to increase the flow of urine it stimulates the vagus nerve usually more pronounced in elderly men with benign prostatic hyperplasia large prostates . The vagus nerve stimulus causes slowing down of the heart bradycardia and severe hypotension drop in blood pressure . The heart cannot perform as a pump effectively because insufficient blood comes to it. Treatment There is no specific treatment for micturition syncope. General advice to men who have a micturition syncope is to sit while urinating, and to sit on the edge of the bed for a while before getting up and going to the toilet. External links http www.patient.co.uk showdoc 40000734 Micturition Syncope Patient Plus Category Urological conditions disease stub zh ... more details
In medicine , the Faget sign medicine sign is the unusual constellation of fever and bradycardia a slow pulse . It is often seen in yellow fever . Fever is usually accompanied by tachycardia a fast pulse , an association known by the eponym Liebermeister s rule . Faget sign is also seen in Typhoid Fever tularaemia brucellosis Colorado tick fever Some pneumonia s Legionella pneumonia and Mycoplasma pneumonia Drug Fever It is named after Jean Charles Faget , who characterized it in 1859. ref WhoNamedIt synd 3753 ref ref Jean Charles Faget. tudes m dicale de quelques questions importantes pour la Louisiane, et expos succinct d une end mie palud enne de forme catarrhale qui a s vi la Nouvelle Orl ans, particuli rement sur les enfants, pendant l epid mie de fi vre jaune de 1858. New Orleans, 1859. ref References reflist med sign stub Eponymous medical signs for infectious disease Category Medical signs pl Objaw Fageta ... more details
Infobox disease Name Myxedema coma ICD10 ICD10 E 03 5 e 00 DiseasesDB OMIM MedlinePlus eMedicineSubj eMedicine mult MeshName MeshNumber eMedicineTopic Myxedema coma is state of decompensated hypothyroidism . The patient may have lab values identical to a normal hypothyroid state, but a stressful event infections, MI, CVA, drugs, etc. precipitates the myxedema coma state. Primary symptoms of myxedema coma are altered mental status and hypothermia. Hypoglycemia, hypotension, hyponatremia, bradycardia, and hypoventilation may also occur. ref http patients.uptodate.com topic.asp?file thyroid 11535 Myxedema Coma. UpToDate Online 15.2. ref Myxedema , although included in the name, is not necessarily seen in myxedema coma. ref stepup to medicine ref References reflist Treatment is with High doses of T4 and T3 300 mcg , corticosteroids, warm blankets and Fluids. External links http emedicine.medscape.com article 123577 overview Myxedema coma or crisis eMedicine DEFAULTSORT Myxedema Coma Category Thyroid disease Category Disease stubs med stub de Myx demkoma ru ... more details
A paracervical block is an anesthetic procedure used in obstetrics and gynecology , in which a local anesthetic is injected into between two to six sites at a depth of 3 7 mm alongside the vaginal portion of the cervix in the Vaginal fornix vaginal fornices . ref http www.bostonscientific.com templatedata imports collateral Gynecology techspot hta anapharma.pdf paracervical block By Robert Nadelberg. Copyright 2007 by Boston Scientific Corporation ref It is used for various obstetric and gynecologic procedures, such as hysteroscopy and vacuum aspiration . It is as efficient as intracervical block , according to a study on women undergoing vacuum aspiration with lidocaine as anesthetic agent. ref cite pmid 19384120 ref References Cunningham, 22 e, pp 477 489 reflist It has been shown to be associated with fetal bradycardia Further reading http www.bostonscientific.com templatedata imports collateral Gynecology techspot hta anapharma.pdf paracervical block By Robert Nadelberg. Copyright 2007 by Boston Scientific Corporation Category Obstetrical procedures Category Female genital procedures Category Regional anesthesia ... more details
who have sinus bradycardia , atrioventricular block , cardiogenic shock, or overt cardiac failure. The drug has been associated with bradycardia and hypertension . Beta blockers Antiglaucoma preparations ... more details
LVH is usually dismissed in the young and fit. The EKG can detect sinus bradycardia , a resting ... by this syndrome show a decrease in such structural changes and in bradycardia with detraining ... more details
in the extremities and around the mouth, low blood pressure and sinus bradycardia . In higher doses symptoms can include loss of coordination, severe and progressive muscular weakness, bradycardia and, paradoxically ... more details
nerve X , which is part of the autonomic nervous system. This causes bradycardia and peripheral vasoconstriction ... reflex is not induced when limbs are introduced to cold water. Mild bradycardia is caused by subjects ... the greatest bradycardia effect is induced when the subject is holding breath with face submerged ... more details
contractility, heart rate, and wall stress. ADRs include Verapamil hypotension , bradycardia , constipation Diltiazem hypotension, bradycardia Nifedipine hypotension Propranolol asystole , asthma ... with AV node dysfunction and or patients on other medications which might cause bradycardia i.e. ... Beta receptor blockers since they may cause severe bradycardia and other potential side effects. Corrective ... more details
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