Key result
Laparoscopic cholecystectomy successfully resolved symptomatic sinus bradycardia (Cope's sign) in a patient with acute calculous cholecystitis, highlighting the cardio-biliary reflex.
Why the study?
Acute cholecystitis may present with cardiovascular manifestations like cardiac ischemia leading to detailed cardiac workup without obvious cardiac pathology.
Case Report (n=1)
Acute cholecystitis can present with reflex sinus bradycardia (Cope's sign) that resolves after cholecystectomy, highlighting the importance of recognizing this cardio-biliary reflex to avoid unnecessary cardiac workup.
Answers are grounded in this paper and cite their sources.
Supports awareness of cardio-biliary reflex in unexplained bradycardia; hypothesis-generating and should not yet change practice.
Acute cholecystitis may present cardiovascular manifestation like cardiac ischemia leading to detailed cardiac workup without any obvious cardiac pathology. Here we describe a case who presented with typical signs and symptoms of cholecystitis exhibiting sinus bradycardia. This reflexive bradycardia was a result of autonomic vagal innervation and was resolved after cholecystectomy. This case highlights the importance of the cardio-biliary reflex and recommends clinicians ensure expedited management of cholecystitis to avoid unnecessary extensive cardiac workup.
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Mainali et al. (2022) conducted a case report in Acute calculous cholecystitis with symptomatic sinus bradycardia (Cope's sign) (n=1). Laparoscopic cholecystectomy was evaluated on Resolution of sinus bradycardia. Laparoscopic cholecystectomy successfully resolved symptomatic sinus bradycardia (Cope's sign) in a patient with acute calculous cholecystitis, highlighting the cardio-biliary reflex.
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