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Title: | High spinal cord injury precipitating syncope: a rare indication for pacemaker insertion. | Austin Authors: | Khan, Isa;Scully, Timothy G;Teh, Andrew W ;Wong, Geoffrey R | Affiliation: | Cardiology | Issue Date: | 10-Oct-2023 | Date: | 2023 | Publication information: | BMJ Case Reports 2023-10-10; 16(10) | Abstract: | The current evidence for vasovagal syncope management is that cardiac pacing is only indicated in a highly select group of patients where symptoms can be linked to bradycardic episodes. High spinal cord injury can lead to autonomic dysfunction and sympathetic nervous system hypoactivity. A high spinal cord injury can theoretically precipitate profound bradycardia leading to haemodynamic instability and syncope. A patient in his 50s with a history of C2 spinal injury was admitted to our tertiary centre for management of what was initially thought to be septic shock causing hypotension and syncope. With evidence to suggest this patient's presentation may be profound reflex syncope in the context of unopposed parasympathetic signalling, consensus was reached to implant a permanent pacemaker. Remarkably, the patient's haemodynamics stabilised and there were no further episodes of syncope. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/34013 | DOI: | 10.1136/bcr-2023-255020 | ORCID: | 0000-0002-1104-3511 |
Journal: | BMJ Case Reports | PubMed URL: | 37816572 | ISSN: | 1757-790X | Type: | Journal Article | Subjects: | Adult intensive care Arrhythmias Spinal cord Bradycardia/etiology Bradycardia/therapy Cardiac Pacing, Artificial/adverse effects Pacemaker, Artificial/adverse effects Spinal Cord Injuries/complications Syncope/therapy Syncope/complications Syncope, Vasovagal/etiology Syncope, Vasovagal/therapy |
Appears in Collections: | Journal articles |
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