 bpm

 Normal sinus rhythm : p-waves followed by a QRS complex, then a T-wave. In a normal HR, sinus node creates an electrical impulse to right and left atrial muscles creating electrical impulses on the electrocardiogram (ECG) shown as the p-wave. An impulse travels through the atrioventicular node causing a slower rate. A pause (PR interval) is created before the ventricles are stimulated. Blood from the atria and into the ventricles and into the body. Ventricular contraction are represented as QRS waves. T-wave follows representing ventricles relaxing. Normal sinus rhythm indicates the rhythm of the heart, which can be up to bpm for a newborn, bpm for a child and bpm for an adult.

o no problems typically associated with rhythm o no treatment generally associated with this rhythm

 Less than 60 bpm

 Rate: 60bpm, P-P interval, regular, R-R interval regular. P wave-positive (upright) in Lead II one P wave precedes each QRS complex. P waves look alike. PR interval 0.12 to 0.20 seconds and constant from beat to beat. QRS duration 0.10 seconds or less unless an intraventricular conduction delay exists

Heart tissue damage related to aging, heart disease or heart attack Heart disorder present at birth (congenital heart defect) Infection of heart tissue (myocarditis) A complication of heart surgery Underactive thyroid gland (hypothyroidism) Imbalance of electrolytes, mineral-related substances necessary for conducting electrical impulses Obstructive sleep apnea, the repeated disruption of breathing during sleep Medications, including some drugs for other heart rhythm disorders, high blood pressure and psycho

 Sinus bradycardia is most often asymptomatic. However, symptoms may include the following:  ◦Syncope  ◦Dizziness  ◦Lightheadedness  ◦Chest pain  ◦Shortness of breath  ◦Exercise intolerance

 Only Treated if symptomatic  Some of the different medications used in the treatment of sinus bradycardia include:  Atropine  AtroPen  Atropine-Care  Isopto Atropine  Sal-Tropine  Dioptic's Atropine Solution  Minim's Atropine Solution  Tropyn Z

 More than 100 bpm

 With very fast heart rates the P waves may be hidden in the preceding T wave, producing a ‘camel hump’ appearance.

 Rate is 101 to 180 bpm, Rhythm P-P interval regular R-R interval regular, Pwave positive (upright) in lead II, one precedes each QRS complex. P waves look alike. PR interval seconds, QRS duration 0.10 sec or less

 Exercise  Pain, anxiety  Hypoxia, hypercarbia  Acidaemia  Sepsis, pyrexia  Pulmonary embolism  Hyperthyroidism

 Usually asymptomatic, if symptoms are present they may include the following:  A racing heart rate or palpitations  The feeling of the heart pounding in the chest.  Dizziness in some cases  Actual syncope (fainting)  Consistently fast heart rate (above 100 BPM) even at rest, although some nights it seems to slow to around 80 BPM  Periodic chest pain, sometimes sharp, others constraining and chest "pressure"  Out of breath most times  Increased fatigue  Intolerance to exercise or any type of physical activity, even walking up a few stairs  Severe anxiety

 beta blockers  calcium channel blockers  antiarrhythmic drugs.