Cheyne-Stokes Respiration and Auriculoventricular Conduction

Comeau, Wilfrid J.

doi:10.1056/nejm193812222192501

Cited by 10 publications

(2 citation statements)

References 6 publications

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“…13,14 Heart block has developed in association with the respiratory alkalosis of CSR. 15,16 Abrupt changes in pulse amplitude and pulsus alternans as reported here appear as a result of CSR. The rapid switching of cardiac activity may be related to the myocardial sensitization of respiratory alkalosis.…”

Section: Discussionmentioning

confidence: 64%

Cheyne–Stokes respiration, periodic circulation, and pulsus alternans in spinal cord injury patients

Frisbie

Sharma

2005

Spinal Cord

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Study design: Case reports. Objectives: To describe Cheyne-Stokes respiration (CSR) and associated circulatory abnormalities in three patients with spinal cord lesions. Setting: Veterans Administration Hospital, USA. Subjects: One paraplegic patient with coronary artery disease in congestive heart failure, one tetraplegic patient with alcoholic cardiomyopathy and postural hypotension, and one tetraplegic complete patient with cardiomegaly, severe aortic atherosclerosis, and postural hypotension. Methods: Breathing activity was measured with a nasal thermistor or abdominal stretch transducer. Cardiac activity was estimated with a photoelectric sensor for cutaneous blood flow placed on the forehead or a piezoelectric transducer for pressure positioned over an artery or the cardiac apex. Tracings were drawn on a strip chart recorder. The subjects were at rest in semireclining positions. Results: Survey times were 17-21 min, and cycling periods were 41-72 s. Periodic changes in the depth of breathing were accompanied by periodic changes in amplitude of forehead cutaneous pulse, blood pressure, or apical cardiac impulse in all patients. Peak circulation occurred at or following peak respiration. In addition, cyclical pulsus alternans occurred in two patients. Conclusion: Three spinal cord injury patients sustained CSR and circulatory periodicity associated with cardiac disease and postural hypotension.Spinal Cord (2005) 43, 385-388.

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Section: Discussionmentioning

confidence: 64%

Cheyne–Stokes respiration, periodic circulation, and pulsus alternans in spinal cord injury patients

Frisbie

Sharma

2005

Spinal Cord

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“…Further support of this explanation may be found in two observations. First, the pusIe retardation can be completely inhibited by atropine, the drug having no effect on the respiration (5,20).…”

Section: Ivar Wernermentioning

confidence: 99%

Cheyne‐stokes Respiration Associated With Rhythmic Pupillary Changes

Werner

1951

Acta Psychiatr Scand

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Nearly a century ago Stokes (23) published the first comprehensive description of what is now called Cheyne-Stokes respiration. Since then a great many articles dealing with the same and similar subjects have appeared. The phenomenon is not very uncommon and the typical clinical picture is familiar to everyone in the medical profession. However, it seems to be less well-known that certain other periodical symptoms may accompany the respiratory changes. In this respect the following case may be of interest.;\led. Clin. nr. 558/1950. Widow, aged 74. The last 3 years she had been suffering from increasing shortness of breath, anginal pains and general infirmity. Her relatives had noticed that she had developed a very poor memory during the last few years. The last month she had got severe vertigo, swollen arms and legs and could hardly manage to stand upright for a few minutes.On admittance dgspnoea, pronounced peripheral cyanosis and oedema of the legs were to be registered. Her mental abilities seemed to be impaired. The heart was enlarged, the blood pressure 200/100, there was auricular fibrillation and liver congestion. The main laboratory findings were moderate albuminuria and a nonprotein nitrogen content in serum of 44 mgm per cent. (3 days later the NPN value had risen to 74 mgm per cent.).During the first day a t the hospitaI she became more disorientated. She now and then left her hed and walked out in the wards speaking lots of meaningless words a n d making wild gestures with her arms. She was accordingly given slight doses of morphine and barbiturate preparations. After a few days of quietness she again grew agitated and mas again given a moderate dose of morphine. After that she fell asleep and in a few hours she developed a typical Cheyne-Stokes respiration which lasted until her death 5 days later.During apnoea she was deeply unconscious and lay entirely motionless, while no reflexes were to be elicited. At thc onset of respiration she began to move in the bed and at hypcrpnoea she lay tossing about waving her arms. In apnoea the

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