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Related Experiment Videos

Recurrent paroxysmal complete heart block induced by vomiting.

D Mehta1, S H Saverymuttu, A J Camm

  • 1Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.

Chest
|August 1, 1988
PubMed
Summary

Vomiting can trigger dangerous heart rhythm issues like asystole through a vagovagal reflex. This reflex is initiated by upper esophageal distension, causing syncope and bradycardia.

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Area of Science:

  • Cardiology
  • Gastroenterology
  • Autonomic Nervous System

Background:

  • Vomiting is a common symptom with various potential causes.
  • Syncope, or fainting, can result from transient cerebral hypoperfusion.
  • Autonomic dysfunction can manifest in complex cardiovascular and gastrointestinal symptoms.

Observation:

  • A patient presented with a 40-year history of vomiting episodes.
  • These vomiting episodes were consistently associated with syncope.
  • Both spontaneous and induced vomiting precipitated cardiac events.

Findings:

  • Vomiting predictably led to sinus bradycardia, atrioventricular block, and ventricular asystole.
  • Clinical and laboratory investigations identified the mechanism.

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  • The complication was attributed to a vagovagal reflex.

    • Implications:

    • Upper esophageal distension initiates a vagovagal reflex.
    • This reflex can cause severe cardiac arrhythmias during vomiting.
    • Understanding this mechanism is crucial for managing similar cases and preventing adverse events.