Bezold–Jarisch reflex-mediated asystole during dobutamine stress testing: a case report. Issue 6 (15th November 2020)

• Record Type: Journal Article
• Authors: Hossain, Nimrah; Hossain, Naseem; Al-Sadawi, Mohammed; Haq, Salman
• Editors: Sayers, Max; Christian Fielder, Camm; Bogdan, Enach; Jonathan M, Behar; Max, Sayers; Vishal Shahil, Mehta
• Is Part Of: European heart journal. Volume 4:Issue 6(2020)
• Page Start: 1
• Page End: 6
• Publication Date: 2020-11-15
• Subjects: Bezold–Jarisch reflex -- Asystole -- Dobutamine stress testing -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytaa348
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: The Bezold–Jarisch reflex (BJR) is a cardioinhibitory parasympathetic response to activation of ventricular mechanoreceptors, which can result in bradycardia, atrioventricular block, or asystole. This phenomenon has been triggered by acute myocardial ischaemia, intra-arterial nitroglycerine use, natriuretic peptides, and with exceptional rarity, in middle-aged women only, by dobutamine infusion during stress echocardiography. Case summary: We present the case of a 61-year-old woman who suffered a 5.1-s sinus pause during her 20 μg/kg/min infusion of dobutamine. Recovery was immediate following termination of dobutamine infusion. Concurrent echocardiography was normal, and subsequent cardiac catheterization and electrophysiologic study were normal. Discussion: This is the fifth documented case of a severe BJR causing asystole during dobutamine infusion, which adds to the accumulating evidence supporting the benign nature of the condition.