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Related Concept Videos

Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
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Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

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Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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Dysrhythmias I: Introduction01:15

Dysrhythmias I: Introduction

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Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Recurrent syncopal events preceded by transient abnormal gait disturbance.

Nathan Leung1, Katie Hyde2, Lucy Pollock2

  • 1Care of the Elderly, Somerset NHS Foundation Trust, Taunton, UK 09eleungnOSCE@gmail.com.

BMJ Case Reports
|August 4, 2025
PubMed
Summary

This study highlights severe orthostatic hypotension (OH) as a cause of recurrent syncope and transient gait disturbances, exacerbated by alcohol. Further research is needed for better diagnosis and management of this condition.

Keywords:
Geriatric medicineMovement disorders (other than Parkinsons)

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Area of Science:

  • Neurology
  • Cardiology
  • Geriatrics

Background:

  • Recurrent transient loss of consciousness (syncope) with preceding gait abnormalities is a complex clinical presentation.
  • Standard investigations including ECG, echocardiogram, and neuroimaging were inconclusive in a patient with these symptoms.

Purpose of the Study:

  • To investigate the underlying cause of recurrent syncope and transient gait disturbances in an elderly patient.
  • To explore the role of orthostatic hypotension (OH) and alcohol consumption in this presentation.

Main Methods:

  • A comprehensive workup was performed, including cardiovascular and neurological assessments.
  • A positive tilt table test was crucial in diagnosing severe orthostatic hypotension.

Main Results:

  • The patient experienced recurrent syncope associated with transient abnormal posture and gait, including leg stiffening, shuffling gait, and ataxia.
  • Severe orthostatic hypotension (OH) was confirmed via a positive tilt table test, explaining the syncopal episodes.
  • Acute alcohol consumption was identified as a significant exacerbating factor for OH and subsequent cerebral hypoperfusion.

Conclusions:

  • Severe orthostatic hypotension, particularly when exacerbated by alcohol, can manifest as recurrent syncope with transient gait disturbances.
  • This case underscores the importance of considering OH in patients with unexplained syncope and gait abnormalities.
  • Further documentation and research are essential for refining diagnostic and management strategies for such complex cases.