Sick Sinus Syndrome: The Daily PANCE Blueprint
Which of the following is the treatment of choice for a stable patient with sinus node dysfunction?
A. Intravenous epinephrine
B. Transcutaneous pacing
C. Oral theophylline
D. Permanent pacemaker
E. Transvenous pacing
Answer and topic summary
The answer is D. Permanent pacemaker
Sinus node dysfunction (SND), also known as sick sinus syndrome, is characterized by abnormal sinus node function leading to bradycardia, pauses, or chronotropic incompetence. Symptoms may include fatigue, dizziness, syncope, or presyncope. In stable patients, the definitive treatment is a permanent pacemaker to prevent symptomatic bradycardia. In unstable patients, temporary pacing or pharmacologic support (e.g., atropine, epinephrine) may be necessary while awaiting definitive therapy.
Incorrect Answers:
- Intravenous epinephrine: May transiently increase heart rate but is not a long-term solution for SND.
- Transcutaneous pacing: Used for unstable patients but not appropriate for stable cases.
- Oral theophylline: Occasionally used in patients who are not pacemaker candidates, but it is not first-line therapy.
- Transvenous pacing: A temporary measure for unstable patients before pacemaker placement.
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Covered under ⇒ PANCE Blueprint Cardiology ⇒ ⇒
