Key result
Postoperative nausea and vomiting linked to recurrent syncope and ventricular asystole via hypersensitive vagal response.
Case Report (n=1)
Postoperative nausea and vomiting can trigger severe vagal responses leading to high-degree AV block and ventricular asystole in otherwise healthy patients.
Answers are grounded in this paper and cite their sources.
Postoperative nausea may provoke transient high-grade AV block and syncope after noncardiac surgery; leaves open whether antiemetic strategies reduce such events.
Summary A 67‐year‐old, otherwise healthy female, developed recurrent syncope and ventricular asystole immediately after an uncomplicated total knee arthroplasty. The syncope was preceded by postoperative nausea and vomiting. The ECG findings during these episodes revealed high‐degree atrioventricular block followed by ventricular pauses, making it impossible to rule out a serious atrioventricular conduction abnormality. Further electrophysiological evaluation revealed that the cardiac conducting system was normal. Vagal dependence could not be confirmed; however a hypersensitive vagal response to postoperative nausea and vomiting appeared to be the most likely explanation.
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Sakai et al. (2015) conducted a case report in Syncope and ventricular asystole (n=1). Postoperative nausea and vomiting was evaluated on Syncope and ventricular asystole. Postoperative nausea and vomiting triggered recurrent syncope and ventricular asystole in a 67-year-old female, likely due to a hypersensitive vagal response.
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