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

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??g/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.

SUBMITTER: Hossain N

PROVIDER: S-EPMC7837248 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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

Hossain Nimrah N Hossain Naseem N Al-Sadawi Mohammed M Haq Salman S

European heart journal. Case reports 20201115 6

<h4>Background</h4>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.<h4>Case summary</h4>We present the case of a 61-yea ...[more]

PMID: 33532694

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