Sinus node dysfunction symptoms

Typical symptoms of lithium intoxication are summarized in Table 2 [122-127]. The clinical picture of hthium intoxication is dominated by neuromuscular and cerebral symptoms in mild cases apathy, muscle weakness, tremor, and unsteady gait are seen. In more severe cases speech disturbances, myoclonic twitching, coma and convulsion can occur. Pulse irregularities and circulatory collapse may supervene. Lithium often causes T-wave flattening or inversion on the electrocardiogram, but clinically important cardiovascular effects are rare, with sinus-node dysfunction reported most often [123]. Residual neurological sequelae consisting of cerebellar dysfunction with ataxia, neuropathy and supra-bulbar symptoms are not unusual. 

The only effective treatment for symptomatic sinus node dysfunction due to an intrinsic cause is pacing. Treatment of the condition is directed at symptoms. However, as every clinician knows, correlation of symptoms with a specific arrhythmia is not always possible in a condition with an episodic nature. 

To summarize, at the present time there is no definitive invasive diagnostic method for evaluating the patient suspected of sinus node dysfunction. Most commonly, the clinician will have to depend on extended ECG monitoring via standard or implanted event recorders to correlate symptoms with sinus node dysfunction. In many cases, the clinician must rely on clinical history and indirect signs of sinus node dysfunction, and empiric pacing therapy may be required in specific cUnical situations. 

Sinus node dysfunction with correlation of symptoms during age-inappropriate bradycardia. The definition of bradycardia depends on age... 

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