Key result
Head-up tilt test triggers vasovagal syncope and subsequent cardiac arrest requiring CPR.
Case Report (n=1)
This case highlights the rare risk of cardiac arrest due to prolonged vasovagal reflex during recovery from a head-up tilt test.
Clinicians should prepare for rare arrest in tilt recovery; this case leaves open protocol modifications.
A 76-year-old man with a history of frequent syncope in youth and in the last 5 years was referred for a head-up tilt test. During the head-up tilt test, he developed a classical vasovagal reflex syncope. On immediate return to the supine position, the patient regained consciousness. Shortly afterward, the heart rate slowed distinctly and the patient became unresponsive with undetectable blood pressure. Chest compressions were initiated with return of spontaneous circulation 2 minutes later. Thereafter, the patient regained consciousness without neurological sequelae. This case illustrates cardiac arrest due to prolonged vasovagal reflex.
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Zyśko et al. (2016) conducted a case report in Vasodepressor syncope (n=1). Head-up tilt test was evaluated. A head-up tilt test in a 76-year-old man induced vasovagal syncope followed by cardiac arrest during recovery, requiring chest compressions with return of spontaneous circulation after 2 minutes.
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