Electrocardiograms are critical for diagnosing Adams-Stokes syndrome caused by paroxysmal third-degree AV block, as patients often lack cardiac symptoms and have normal pulse rates between attacks.
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ECG findings may support diagnosis in Adams-Stokes syndrome; case-level data leave prospective validation open.
Among I70 patients with Adams-Stokes syndrome, the majority had sinus rhythm between attacks. Clinical and electrocardiographic features of 67 patients in whom syncope was caused by paroxysmal third-degree atrioventricular block are discussed. The patients had normal pulse rates between attacks, their cerebral symptoms were usually not accompanied by cardiac symptoms, and 25 per cent had no symptoms suggesting heart disease. However, in 83 per cent the electrocardiogram showed constantly interventricular conduction disturbances and 7I per cent episodically atrioventricular conduction disturbances. It appears that the diag- nosis, which otherwise may be missed, may be greatly facilitated by electrocardiograms.
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Jensen et al. (1973) studied this question.
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