EKG

Bradycardia

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Bradycardia, Bradyarrhythmia

  • See Also
  1. Unstable Bradycardia
  • Causes
  • Primary
  1. See Drug Induced Bradycardia
  2. Sinus Bradycardia
  3. Sinus Arrhythmia
  4. Sinoatrial Node Block
  5. Sick Sinus Syndrome
  6. Atrioventricular Block
  • Causes
  • Secondary
  1. Approach - simplified top secondary causes to consider in symptomatic Bradycardia (esp. wide complex Bradycardia)
    1. Electrolytes (Hyperkalemia, Hypercalcemia)
    2. Myocardial Ischemia
    3. Hypothermia
    4. Drug Induced Bradycardia (typically with Hypotension)
      1. Calcium Channel Blocker Overdose
      2. Beta Blocker Overdose
      3. Digoxin Overdose
      4. Clonidine Overdose
  2. Electrolyte disturbance
    1. Hypercalcemia
    2. Hyperkalemia
      1. Important cause of Bradycardia that should not be missed
      2. Associated with short P Waves and Tall T Waves
    3. BRASH Syndrome
      1. Bradycardia
      2. Renal Failure
      3. AV Blocker (e.g. Beta Blocker or Calcium Channel Blocker)
      4. Shock (out of proportion to degree of Hyperkalemia, requires fluid Resuscitation and possible pressors)
      5. Hyperkalemia
    4. References
      1. EMCrit (Josh Farkas, MD)
        1. https://emcrit.org/pulmcrit/brash-syndrome-bradycardia-renal-failure-av-blocker-shock-hyperkalemia/
  3. Intracranial cause (Cushing's Reflex or dive reflex)
    1. Neurogenic Shock
    2. Increased Intracranial Pressure (e.g. Head Injury)
  4. Acute ingestions or Poisonings
    1. Opioid Overdose
    2. Gamma Hydroxybutyrate (GHB)
    3. Ciguatera Poisoning
    4. Muscarinic Cholinergic Toxicity
    5. Lead Poisoning
  5. Other conditions
    1. Hypothyroidism
    2. Obstructive Jaundice
    3. Severe Anorexia or starvation
    4. Obstructive Sleep Apnea
  6. Infections
    1. Salmonella typhi
    2. Acute Lassa Fever