Symptomatic Bradycardia

Unstable or Stable Symptomatic Bradycardia

These symptoms can be split into two categories: hemodynamically unstable versus hemodynamically stable. Hemodynamically unstable bradycardias refer to those that lead to a loss of perfusion and are accompanied by hypotension or symptoms that show a lack of brain perfusion (dizziness, syncope, and confusion). Usually, these symptoms are a result of the bradycardia, so fixing the bradycardia might resolve the symptoms.

Chest pain and shortness of breath can accompany either hemodynamically stable or unstable bradycardia. In unstable bradycardia, the lack of perfusion could be the cause of chest pain or dyspnea. In stable bradycardia, other cardiac conditions could be leading to both the symptoms and the bradycardia. Some emergency medical service systems consider bradycardia stable if the only accompanying symptoms are chest pain or shortness of breath. Other systems consider it unstable. Paramedics should always follow their local protocols.

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