Sick sinus syndrome

Clemens Gödel is a freelancer for the medical team.

More about the experts All content is checked by medical journalists.

In sick sinus syndrome (sinus node syndrome, SSS), the so-called sinus node in the heart works incorrectly. It is actually responsible for the formation and the speed of the heartbeat. With this rhythm disturbance, the heart beats too slowly, sometimes too fast in phases. Read all about the syndrome here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. R00I48I46I47I49I45I44

Sick sinus syndrome: description

In sick sinus syndrome, the sinus node in the heart is damaged. The syndrome is common in elderly people whose hearts are weakened. Often they already suffer from another arrhythmia.

Sick sinus syndrome: symptoms

Sick sinus syndrome can go unnoticed in mild forms. However, if the heart beats too slowly or too quickly, symptoms of an abnormal heart rhythm may occur. These include shortness of breath, chest pain, dizziness and fatigue.

Sick sinus syndrome: causes and risk factors

The sinus node in the heart is responsible for generating a heartbeat and its speed. It generates around 60 to 80 electrical signals per minute that are sent to the heart muscle cells. When the muscle cells receive the electrical signal, they contract, creating a heartbeat.

The heart is out of step

In sick sinus syndrome, the sinus node is scarred. As a result, the function of many cells in the sinus node is lost. If the sinus node sends impulses too infrequently, the heart rate slows down. This condition is known as sinus bradycardia. Symptoms such as dizziness, tiredness, or even fainting may occur. Sometimes a slow and a fast heartbeat alternate in sick sinus syndrome.

Sometimes the transmission of electrical signals from the sinus node to the heart muscle cells is temporarily or permanently disturbed. One speaks of a sinoatrial block (SA block). This can make the dizziness and tiredness even worse. In the worst case, no more signals are forwarded.

If the sinus node does not send out any impulses, it is a so-called sinus node arrest (sinus node arrest). The sinus node arrest and the total SA block are life-threatening.

Sick sinus syndrome: diagnosis and examination

As with many cardiac arrhythmias, the diagnosis is made with the help of an electrocardiogram (ECG). With the EKG, the heart currents are measured and recorded using electrodes. A cardiac arrhythmia can therefore be recognized very well. The ECG often has to be written over several days. There are special long-term ECG devices that are worn around the neck for this purpose.

Sometimes the EKG is also written under physical exertion, for example on an exercise bike. The heart rate can only rise insufficiently, which is an indication of the sick sinus syndrome.

In an atropine test, atropine is given through the vein. Atropine actually increases the heart rate. When sick sinus syndrome exists, the heart rate does not increase.

Sick sinus syndrome: treatment

In sick sinus syndrome, a pacemaker must be implanted to act as the sinus node. The pacemaker is usually implanted under the skin above the right breast. The device is connected to the heart via two probes. If the pacemaker fails, the pacemaker can take over. If the heart has a racing heart, medication must be given.

Sick sinus syndrome: disease course and prognosis

With sick sinus syndrome, the risk of a stroke is often increased. Therefore, blood-thinning drugs are administered in such cases. If left untreated, sick sinus syndrome can seriously worsen an existing heart failure.

If the bradycardia was treated with a pacemaker, the prognosis is good. Those affected are mostly symptom-free after the implantation. Since the sick sinus syndrome is often based on another heart disease, this must also be treated.

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