Key result
Defecation syncope in two post-operative patients with preexisting cardiovascular disease led to cardiac arrest and subsequent in-hospital death despite initial return of spontaneous circulation.
Case Report (n=2)
Defecation syncope can lead to fatal cardiac arrest in post-operative patients with preexisting cardiovascular disease, highlighting the potential importance of preventive measures like hydration and stool softeners.
Defecation syncope may precipitate fatal arrest in postoperative patients with cardiovascular disease; case reports leave open whether prevention alters outcomes.
Introduction: The vasovagal response is a normal physiologic response that consists of sequential changes in blood pressure, heart rate, and contractility that resolves spontaneously in normal patients. This normal response can be problematic in patients with a compromised cardiovascular system who require surgery. Case Summary: We report two cases of defecation syncope with cardiac arrest. Both patients had preexisting cardiovascular disease and no premonitory syncope symptoms. Both patients were returned to spontaneous circulation following initiation of ACLS protocol, but died later in the hospital course secondary to complications of cardiac arrest. Conclusion: Promoting hydration, incorporating a stool softener into the medication regimen, and squatting during bowel movement may aid in reducing the risk for syncope and associated cardiac arrest with defecation.
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Bryan Curtis Thomas Hughes (2015) conducted a case report in Defecation syncope with cardiac arrest (n=2). Defecation syncope was evaluated on Cardiac arrest and death. Defecation syncope in two post-operative patients with preexisting cardiovascular disease led to cardiac arrest and subsequent in-hospital death despite initial return of spontaneous circulation.
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