What Causes Bradycardia?

Discussion Bradycardia is a heart rate below what the lowest value that is normal for age. Infants and children have higher heart rates that slowly decrease with age to adult levels. It is usually noted as an incidental finding because of increased vagal tone. Reasons for cardiology referral include associated heart murmur, syncope especially if associated with exercise or unusual triggers, other signs such as chest pain or palpitations, family history of sudden cardiac death, congenital heart disease or familial heart disease, bradycardic medication use, or unusual symptoms associated with the concern. Severe bradycardia that causes poor cardiac output is a medical emergency. Fortunately most children have mild bradycardia which may have no symptoms or can manifest as dizziness, syncope, exercise intolerance or fatigue. Evaluation includes a good history and physical examination. Electrocardiogram may determine a rhythm abnormality but often an ambulatory Holter monitoring will be needed as the bradycardia and/or rhythm may be intermittent. Echocardiogram may be appropriate if congenital heart disease is suspected. Exercise stress testing is usually not need but can determine if the heart is appropriately responsive during exercise. Learning Point The differential diagnosis of bradycardia includes: Athletes, well trained Hypervagotonia this is a sinus bradycardia Apnea and bradycardia in infants Breathholding spells Coughing Emesis Gastroesophageal reflux Increased...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news

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