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The Heartbeat that Hesitates: Quick H.I.T.s for Emergency Bradycardia
1Department of Emergency Medicine, University of Maryland School of Medicine, 110 S Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
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Bradycardia has a broad differential, which can be narrowed by history, physical examination, and electrocardiogram. Symptomatic cases often stem from sick sinus syndrome or atrioventricular block. High-risk, cannot-miss causes include hyperkalemia, myocardial ischemia, toxins, hypoxia, increased intracranial pressure, and thyroid dysfunction. Early recognition is critical to prevent progression to bradycardic arrest. Management ranges from targeted interventions and antidotes to pharmacologic and electrical therapies.
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