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Related Experiment Videos

Atrioventricular block secondary to straining.

M S Mikhail, D Thangathurai, J F Viljoen

    Critical Care Medicine
    |July 1, 1987
    PubMed
    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.

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    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.

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