https://idwiki.org/index.php?action=history&feed=atom&title=Bradycardia 2026-05-13T01:37:34Z Revision history for this page on the wiki MediaWiki 1.43.8 https://idwiki.org/index.php?title=Bradycardia&diff=8085&oldid=prev 2021-10-21T13:40:47Z

<p>Created page with &quot;== Differential Diagnosis == * Sinus node dysfunction * Medications, including parasympathomimetic drugs (<a href="/index.php?title=Acetylcholine&amp;action=edit&amp;redlink=1" class="new" title="Acetylcholine (page does not exist)">acetylcholine</a>, <a href="/index.php?title=Carbachol&amp;action=edit&amp;redlink=1" class="new" title="Carbachol (page does not exist)">carbachol</a>, [[acetylcholinesterase inhibitors]...&quot;</p> <p><b>New page</b></p><div>== Differential Diagnosis ==<br /> <br /> * Sinus node dysfunction<br /> * Medications, including parasympathomimetic drugs ([[acetylcholine]], [[carbachol]], [[acetylcholinesterase inhibitors]]), sympatholytic drugs ([[beta blockers]], [[methyldopa]], [[clonidine]]), [[opioids]] and other sedatives, [[cimetidine]], [[digoxin]], non-DHP CCBs ([[diltiazem]] and [[verapamil]]), [[ivabradine]], [[amiodarone]] and other antiarrhythmic drugs, [[sofosbuvir]] and [[daclatasvir]] (in patients on [[amiodarone]]), [[lithium]], chemotherapies ([[thalidomide]], [[lenalidomide]], [[paclitaxel]]), and organophosphates<br /> * [[Acute myocardial infarction]]<br /> * [[Obstructive sleep apnoea]]<br /> * Exaggerated vagal tone<br /> * [[Increased intracranial pressure]]<br /> * Infections, including [[Lyme disease]], [[Chagas disease]], [[legionellosis]], [[psittacosis]], [[Q fever]], [[typhoid fever]], [[typhus]], [[babesiosis]], [[Malaria chemoprophylaxis]], [[leptospirosis]], [[yellow fever]], [[dengue fever]], [[trichinosis]], [[Rocky Mountain spotted fever]]<br /> * Miscellaneous causes, including [[hypothyroidism]], [[anorexia nervosa]], [[hypothermia]], severe prolonged [[hypoxia]], [[long QT syndrome]], [[catecholaminergic polymorphic ventricular tachycardia syndrome]]<br /> <br /> == Investigations ==<br /> <br /> * Confirm sinus bradycardia with [[ECG]] and exclude [[heart block]]<br /> * Vital signs including pulse oximetry<br /> * Review medications and exposure history<br /> * [[TSH]] to exclude [[hypothyroidism]]<br /> <br /> == Management ==<br /> <br /> === Asymptomatic Patients ===<br /> <br /> * Often only need to be monitored<br /> <br /> === Symptomatic, Hemodynamically Unstable Patients ===<br /> <br /> * [[Atropine]] 0.5 mg IV push q3-5min to maximum total dose of 3 mg<br /> * For atropine-resistant hemodynamically-significant bradycardia:<br /> ** Consider temporary cardiac pacing<br /> ** Consider infusion of [[dopamine]] or [[epinephrine]]<br /> * Continuous cardiac telemetry<br /> <br /> === Symptomatic, Hemodynamically Stable Patients ===<br /> <br /> * Rule out [[acute coronary syndrome]] and manage as appropriate<br /> * Investigate for and manage other causes<br /> * Review medications and hold any that may be contributing<br /> * Assess for sinus node dysfunction<br /> <br /> [[Category:Cardiology]]<br /> [[Category:Acute care medicine]]</div>

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