A Heart Stopping Case of the Bezold-Jarisch Reflex

Parent, Marc-Etienne; Lepage, Serge

doi:10.1155/2015/359401

Cited by 7 publications

(9 citation statements)

References 5 publications

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“…A further common feature between our case and the case reported by Brosnan et al (2008) is the infusion of dobutamine. Dobutamine has been reported in both dogs and humans to be capable of inducing a BJR reflex with associated periods of asystole (Hofmeister et al 2005;Parent and Lepage 2015). Dobutamine was ceased abruptly at the end of surgery, immediately following transition from Trendelenburg to dorsal recumbency; this abrupt cessation may have precipitated a rapid drop in MAP and resultant hypotension.…”

Section: Discussionmentioning

confidence: 99%

Successful cardiopulmonary resuscitation in an adult horse following cardiovascular collapse on recovery from general anaesthesia in the Trendelenburg position

Duggan¹,

Schofield²,

Vermedal³

2021

Equine Veterinary Education

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Equine anaesthesia is associated with a high risk of perioperative morbidity and mortality, particularly in the recovery period. Cardiovascular collapse and cardiopulmonary arrest (CPA) have been reported to account for one-third of anaesthesia-related perioperative deaths in the horse. This case report describes the successful cardiopulmonary resuscitation of a healthy adult Thoroughbred mare that developed cardiovascular collapse and subsequent CPA following positioning in the recovery box after general anaesthesia in the Trendelenburg position. Cardiopulmonary resuscitation (CPR) was instigated and included thoracic compressions, intermittent positive pressure ventilation and adrenaline administered via the intravenous and intra-tracheal routes. Return of spontaneous circulation (ROSC) was detected 5 min and 50 s after the start of CPR. A stable stance was achieved approximately 100 min after ROSC. The mare was discharged from the hospital 3 days later with no known complications. To the authors' knowledge, this is the first case report documenting CPA following general anaesthesia in the Trendelenburg position in a horse, with subsequent successful CPR. The precise cause of the CPA is unknown but a number of plausible hypothesis are discussed including hypoventilation and a Bezold-Jarisch reflex.

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Section: Discussionmentioning

confidence: 99%

Successful cardiopulmonary resuscitation in an adult horse following cardiovascular collapse on recovery from general anaesthesia in the Trendelenburg position

Duggan¹,

Schofield²,

Vermedal³

2021

Equine Veterinary Education

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“…An echocardiogram done immediately after resuscitation showed no apparent abnormalities, coronary angiography was normal. 11 …”

Section: Discussionmentioning

confidence: 99%

“… 2 , 12 In three of four cases, the patient received intravenous atropine, which is the recommended treatment for suspected asystole or bradycardia caused by cardioinhibitory reflexes. 8 , 10 , 11 …”

Section: Discussionmentioning

confidence: 99%

Bezold–Jarisch reflex-mediated asystole during dobutamine stress testing: a case report

Hossain

Al‐Sadawi

et al. 2020

European Heart Journal - Case Reports

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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.

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“…Bezold-Jarisch reflex (BJR) was significant present in CKD group and this reminds us of the potential complications and importance of closely monitoring patients during dobutamine infusion. Although Bezold-Jarisch reflex (BJR) is a benign condition that can be abolished by dobutamine infusion cessations or atropine injection, but there were reported severe cases of DSE induced asystole [12]. BJR has been described in patients with heart failure or inferior or posterior wall ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…Bezold-Jarisch reflex was considered present when the heart rate decreases with continuous incremental dobutamine infusion. It was transient with spontaneously relieved or 0.5 mg atropine bolus IV if persists more than 1 minute [12].…”

Section: Images Interpretationmentioning

confidence: 99%

Dobutamine Stress Echocardiography in Chronic Kidney Disease Patients Candidates for Renal Transplantation

Aboualia¹

2020

CCR

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A Heart Stopping Case of the Bezold-Jarisch Reflex

Cited by 7 publications

References 5 publications

Successful cardiopulmonary resuscitation in an adult horse following cardiovascular collapse on recovery from general anaesthesia in the Trendelenburg position

Successful cardiopulmonary resuscitation in an adult horse following cardiovascular collapse on recovery from general anaesthesia in the Trendelenburg position

Bezold–Jarisch reflex-mediated asystole during dobutamine stress testing: a case report

Dobutamine Stress Echocardiography in Chronic Kidney Disease Patients Candidates for Renal Transplantation

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