Sick Sinus Syndrome, Complete AV Block Quiz
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Fainting when walking
Off-balance like floating
Irregular heartbeat
Dizziness
Blacking out
Dizziness multiple times
Walking then suddenly fainted / passed out
Not seeing your symptoms? No worries!
What is Sick Sinus Syndrome, Complete AV Block?
These conditions involve issues with the heart's electrical conduction system. Signals may be transmitted too fast, too slow, or not at all to some areas of the heart. Both men and women are affected, and the risk increases with age.
Typical Symptoms of Sick Sinus Syndrome, Complete AV Block
- Losing consciousness during a physical activity
- Fainting
- Family history of sudden death under 50 years old
- Small involuntary eye movements
- Irregular heartbeat
- Dizziness
- Swelling in any body part
- Diagnosed with heart failure at age 45 or younger
Diagnostic Questions for Sick Sinus Syndrome, Complete AV Block
Your doctor may ask these questions to check for this disease:
- Did you faint while walking or doing something?
- Have you fainted recently?
- Do you have a family history of early sudden death (under 50)?
- Do you have small involuntary eye movements?
- Have you been experiencing an irregular heartbeat?
Treatment of Sick Sinus Syndrome, Complete AV Block
Treatment depends on the type of signaling problem and symptom severity. Mild cases may not need treatment, while in some cases a doctor may recommend a pacemaker implantation to deliver electrical impulses if the heart rate is too slow or pauses.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Tatsuya Shiraishi, MD (Cardiology)
Dr. Shiraishi graduated from the Kyoto University School of Medicine. He worked as a cardiologist at Edogawa Hospital, and after joining Ubie, he became the Director of East Nihonbashi Internal Medicine Clinic.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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Sick Sinus Syndrome, Complete AV Block?
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See full list
Symptoms Related to Sick Sinus Syndrome, Complete AV Block
Diseases Related to Sick Sinus Syndrome, Complete AV Block
FAQs
Q.
Heart Rate Too Slow? Why Bradycardia Happens & Medically Approved Next Steps
A.
Bradycardia is a resting heart rate under 60 BPM that can be normal in healthy adults and athletes, but it becomes concerning when it causes symptoms like dizziness, fainting, chest pain, shortness of breath, very low blood pressure, or signs of heart block. There are several factors to consider, from aging of the heart’s electrical system and sick sinus syndrome to AV block, medications, thyroid or electrolyte problems, and prior heart damage; next steps range from monitoring and treating reversible causes to medication changes and pacemaker, with urgent care for red flag symptoms. See below for the full list of causes, warning signs, tests, and step by step guidance.
References:
* Kashou AH, Basit H, Malik A, et al. Bradycardia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493215/
* Daoud EG, Bogun F, Al-Khatib SM, et al. Bradycardia: A Review of the Differential Diagnosis, Evaluation, and Management. Circulation. 2017 Apr 11;135(15):1426-1447. doi: 10.1161/CIRCULATIONAHA.116.023391. PMID: 28400494.
* Olshansky B, Barold SS, Cannom DS, et al. 2021 ACC/AHA/HRS Guidelines for the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Sep 21;144(12):e1-e124. doi: 10.1161/CIR.0000000000001004. Epub 2021 Aug 26. PMID: 34182512.
* Jabbour A, El-Chami M. Bradyarrhythmias: Pathophysiology and Management. Cardiol Clin. 2023 Aug;41(3):365-380. doi: 10.1016/j.ccl.2023.03.003. Epub 2023 Jul 26. PMID: 37575459.
* Kapa S. Bradycardia. Med Clin North Am. 2020 Sep;104(5):765-779. doi: 10.1016/j.mcna.2020.06.002. PMID: 32677953.
Q.
Is it Cardiac Arrest? Why Your Heart Stops and Medically Approved Next Steps
A.
Cardiac arrest is when the heart suddenly stops pumping because of an electrical problem, causing collapse and absent or abnormal breathing; survival depends on immediate action: call emergency services, begin hard and fast chest compressions, and use an AED if available. There are several factors to consider. See below for crucial details on causes, early warning signs, risk factors, diagnosis, and proven treatments and prevention that may change which next steps you take in your healthcare journey.
References:
* Mirzoyev, U. R., & So, E. L. (2021). Sudden Cardiac Arrest. *JAMA*, *325*(24), 2504–2504.
* Rubertsson, S., & Karlberg, H. (2018). Pathophysiology of Cardiac Arrest and Cardiopulmonary Resuscitation. *Journal of Clinical Monitoring and Computing*, *32*(6), 929–934.
* Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., Murphy, S. L., Peberdy, M. A., Smith, E. E., Stevenson, L. W., Topjian, A. A., & Van Zant, N. R. (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. *Circulation*, *142*(16_Suppl_2), S366–S468.
* Perkins, G. D., Sandroni, C., Nolan, J. P., Castrén, M., Chung, S. P., Deakin, C. D., Donnino, M. W., Drennan, I. R., Duff, J. P., Ekmekçi, R., Griffiths, F., Hogan, J., Jones, P., Khoury, A., Lockey, A. S., Marra, R., Merchant, R. M., Morley, P. T., Myatt, N., … Soar, J. (2021). European Resuscitation Council Guidelines 2021: Adult basic life support. *Resuscitation*, *161*, 118–134.
* Al-Khatib, S. M., Stevenson, L. W., & Ackerman, M. J. (2023). Sudden Cardiac Arrest: An Update on Etiology, Management, and Prevention. *Circulation Research*, *133*(4), 314–332.
Q.
Taking Metoprolol? Why Your Heart Rate Slows & Medically Approved Next Steps
A.
Metoprolol slows your heart rate on purpose; a resting rate around 50 to 60 bpm can be fine if you feel well, but under 50 with symptoms needs medical review, and fainting, chest pain, or severe shortness of breath are urgent. Never stop it suddenly; see below for medically approved next steps including how to monitor safely, when to call your doctor, possible dose or timing changes, tests like an ECG or heart monitor, and red flags that could point to a conduction problem.
References:
* Ma, X., Wang, Q., Li, J., & Ma, N. (2022). Beta-Blockers: A Narrative Review of Mechanisms and Clinical Applications. *Current Issues in Cardiology*, *19*(3), 447–458. doi:10.1007/s40114-022-00331-1
* Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. J., Jackson, S. L., Wright, J. T., & 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. (2018). *Journal of the American College of Cardiology*, *71*(19), e127–e248. doi:10.1016/j.jacc.2017.11.006
* Nagy, L., Hancu, A., Varga, S., Kiss, A., Mihali, D., Bârsoian, A. V., Nemeș, T. I., Mihali, C. G., & Luncan, I. (2022). Drug-Induced Bradycardia: A Comprehensive Review. *Cardiology Research and Practice*, *2022*, 9735497. doi:10.1155/2022/9735497
* Messerli, F. H., Bangalore, S., & Bavishi, C. (2018). Cardiovascular Beta-Blockers: Current Uses and Future Perspectives. *Journal of the American College of Cardiology*, *72*(11), 1308–1322. doi:10.1016/j.jacc.2018.06.046
* Wong, E. H., & Krum, H. (2018). Beta-blockers in cardiovascular disease: current state of evidence. *Current Opinion in Cardiology*, *33*(5), 509–514. doi:10.1097/HCO.0000000000000547
Q.
What is lymphatic drainage massage?
A.
Lymphatic drainage massage is a gentle, light-pressure technique that follows lymph pathways to move fluid, reduce swelling, and support immune function and detoxification, often used after surgery or for lymphedema. There are several factors to consider. See below for safety warnings and who should avoid it, what to expect in a session, evidence and costs, how to choose a qualified therapist, and guidance on next steps in your care.
References:
Kozanoglu E, Uygur F, & Irmak MK. (2002). The effects of manual lymphatic drainage technique… Support Care Cancer, 12446494.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines on decompensated cirrhosis… Journal of Hepatology, 29869770.
Biggins SW, Kim WR, & Terrault NA. (2006). Evidence-based incorporation of serum sodium… Liver Transplantation, 16785667.
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Debruyne, P., Rossenbacker, T., & Collienne, C. (2018). Unifocal right-sided ablation treatment for neurally mediated syncope and functional sinus node dysfunction under computed tomographic guidance. Circulation …, 2018.
https://www.ahajournals.org/doi/abs/10.1161/CIRCEP.118.006604John, R. M., & Kumar, S. (2016). Sinus node and atrial arrhythmias. Circulation, 2016.
https://www.ahajournals.org/doi/abs/10.1161/circulationaha.116.018011Peigh, G., Leya, M. V., Baman, J. R., & ... (2020). Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series. … Heart Journal.
https://academic.oup.com/ehjcr/article-pdf/doi/10.1093/ehjcr/ytaa132/35930156/ytaa132.pdf