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Atrioventricular block secondary to straining
Critical Care Medicine
|July 1, 1987
Summary
Straining during bowel movements can cause cardiac arrest in elderly patients due to increased vagal tone. A postoperative patient developed atrioventricular heart block requiring a pacemaker after straining on a commode.
Area of Science:
- Cardiology
- Geriatrics
- Gastroenterology
Background:
- Cardiac arrest during defecation is a known risk, particularly in elderly individuals.
- Increased vagal tone from straining can induce bradycardia and subsequent hypoperfusion.
- Postoperative patients may have altered physiological responses.
Observation:
- A female patient experienced varying degrees of atrioventricular heart block.
- The event occurred while the patient was straining on a bedside commode.
- Symptoms were directly linked to the straining activity.
Findings:
- The patient's atrioventricular heart block was a direct consequence of straining.
- The cardiac event necessitated medical intervention.
- A permanent pacemaker was required to manage the heart block.
Implications:
- Highlights the risk of syncope and cardiac arrest during defecation in vulnerable patients.
- Underscores the importance of monitoring cardiovascular status in postoperative patients.
- Suggests the need for proactive management of straining in at-risk populations.