The Bezold-Jarisch Reflex in a Patient With Stanford Type A Acute Aortic Dissection
| Autor: | Akifumi Miyamoto, Kuniyasu Harimoto, Masatoshi Hori, Tatsuya Kawasaki |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Bradycardia
Male medicine.medical_specialty Dissection (medical) 030204 cardiovascular system & hematology Chest pain Angina 03 medical and health sciences 0302 clinical medicine Heart Rate medicine.artery Internal medicine Reflex Medicine Humans Aortic dissection business.industry Heart Middle Aged medicine.disease Aortic Dissection Bezold–Jarisch reflex Right coronary artery cardiovascular system Emergency Medicine Cardiology 030211 gastroenterology & hepatology medicine.symptom Hypotension business |
| Zdroj: | The Journal of emergency medicine. 59(6) |
| ISSN: | 0736-4679 |
| Popis: | Background The Bezold-Jarisch reflex is a depressor reflex of the heart due to the preferential distribution of vagal nerves in the inferior wall of the left ventricle. We report a case of Stanford type A acute aortic dissection, in which coronary spastic angina caused the Bezold-Jarisch reflex in the acute phase. Case Report A 53-year-old man presented with left chest pain and cold sweating. An electrocardiogram was normal and the high-sensitivity cardiac troponin T level was negative. A diagnosis of Stanford type A acute aortic dissection was made based on computed tomography (CT); there was no evidence of ischemic heart disease on coronary CT angiogram obtained simultaneously. While waiting for emergency surgical repair, chest pain worsened, followed by bradycardia and hypotension, along with ST-segment elevations in the inferior leads, all of which were resolved by conservative treatment. During surgery, no evidence to suggest an extension of the dissection to the ostium of the right coronary artery was observed. Why Should an Emergency Physician Be Aware of This? The present case highlights the importance of recognizing the Bezold-Jarisch reflex because this depressor reflex may require different management than other conditions. |
| Databáze: | OpenAIRE |
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