Q-Could you please explain what S.S.S. (sick sinus...

April 30, 1992|By Dr. Allan Bruckheim, (copyright)Tribune Media Services, Inc.

Q-Could you please explain what S.S.S. (sick sinus syndrome) is, as I have finally been diagnosed after fainting in the hospital. I`m now 77 years old, and am doing better on medication, but have always tired easily.

A-Your present condition, sick sinus syndrome (or sinus node dysfunction syndrome), is most likely unrelated to your previous fatigued periods, for it`s a condition that is more common in older patients.

This condition is most frequently seen in patients who have coronary artery disease, although there are several other conditions that can cause the problem.

The problem is the sinus node-the principal pacemaker of the heart that controls the rhythm and speed of the heartbeat-is not functioning as it should, probably because it`s not getting sufficient blood flow from the heart arteries, which may be affected by arteriosclerosis (hardening of the arteries).

When the sinus node fails to send out the electrical messages that make the heart muscles contract, a heartbeat is either skipped or the time between heartbeats is prolonged. This reduces the amount of blood that is pumped through the heart and reduces the amount of oxygen carried to the brain.

When this occurs, a patient feels weak, dizzy or may faint and pass out completely, as in your case. In other cases, a sick sinus can begin to send out impulses too frequently and the heart rate is increased, a condition known as tachycardia.

While medications can be used to help increase the blood flow, an external pacemaker is used to control the heartbeat when the sinus node no longer may be depended upon to keep the beat strong and regular.

The diagnosis is usually made with the help of a Holter monitor, which is a small, portable device that keeps a record of the heart action for a 24-hour period.

When the record is reviewed, the physician can find the irregular heartbeats that cause the physical symptoms, and evaluate the extent of the problem. This helps in choosing the right medication or making the decision to use a pacemaker instead.

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