7a: Recognizing Bradycardia (2026)
This lesson is the first of two parts about Bradycardia. The first step being its recognition. Bradycardia is defined and the various signs and symptoms it may cause are discussed. The different kinds of Bradycardia are also explained, as well as what happens during the specific event.
"Bradycardia is defined as a heart rate that is lower than what is considered normal for a child’s age. Bradycardia in children and infants should be evaluated, but not all bradycardia needs to be medically managed. Intervention is required when bradycardia is symptomatic and compromises cardiovascular function. This commonly means that the heart is beating too slowly to maintain blood pressure, thereby causing shock, poor tissue perfusion, and/or a change in mental status.
Symptomatic bradycardia may cause a number of signs and symptoms including low blood pressure, pulmonary edema/congestion, abnormal rhythm, chest discomfort, shortness of breath, lightheadedness, confusion, and/or syncope. Bradycardia most commonly becomes symptomatic when it is of new-onset for the individual, which means an acute slowing of the heart rate.
The following are the kinds of bradycardia and what happens during the specific bradycardia event:
Sinus Bradycardia - normal rhythm with a slow rate
First Degree AV Block - PR interval is longer than 0.20 seconds
Type I Second Degree AV Block (Mobitz I/Wenckebach) - PR interval increases in length until QRS complex is dropped
Types II Second Degree AV Block (or Mobitz II) - PR interval is the same length with intermittently dropped QRS complex
Third Degree AV Block (or Complete) - PR interval and QRS complex are not coordinated with each other"
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