Massive weight loss following bariatric surgery can lead to autonomic imbalance manifesting as resting bradycardia and a delayed chronotropic response, which may cause dyspnea on early exertion.
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May warrant arrhythmia monitoring after rapid post-bariatric weight loss; leaves open confirmation in prospective studies.
Bariatric surgery has shown promising outcomes in improving overall morbidity and mortality in morbidly obese patients. Cardiovascular risk reduction from weight loss is well known in the literature. However, little is highlighted about the cardiovascular complications of massive and rapid weight loss associated with bariatric surgery. These complications result mainly from autonomic imbalance manifesting as increased parasympathetic tone and a decrease in sympathetic response. This imbalance is a consequence of hormonal changes associated with massive weight loss. We present a unique case which is a demonstration of the aforementioned changes. Our patient presented with dyspnea during an early phase of exercise with the resolution of symptoms with the continuation of exercise.
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Sagheer et al. (2018) studied this question.
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