 |
Case Report
Bradyarrhythmia in acute massive pulmonary embolism
1 Department of Internal Medicine, Yale New Haven Health - Bridgeport Hospital, Bridgeport, CT 06610, USA
Address correspondence to:
Jay Parekh
Department of Internal Medicine, Yale New Haven Health - Bridgeport Hospital, Bridgeport, CT 06610,
USA
Message to Corresponding Author
Article ID: 101381Z01JT2023
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Tan JW, Parekh J, Shukla A. Bradyarrhythmia in acute massive pulmonary embolism. Int J Case Rep Images 2023;14(1):47–51.ABSTRACT
Pulmonary embolism (PE) can present with a variety of electrocardiographic findings. Bradycardia is a rare finding in acute PE, which typically manifests with sinus tachycardia. Bradycardia in acute PE might arise from the physiologic Bezold–Jarisch reflex, which describes the constellation of bradycardia, peripheral vasodilation, and hypotension. We report the case of a woman in her 60s who was admitted initially for submassive PE and found to have sinus bradycardia. She had progressed to massive PE with acute worsening of atrioventricular conduction block in the setting of atrial flutter. Her bradyarrhythmia resolved and hemodynamics improved after catheter directed thrombolysis. This case revisits the pathophysiology of Bezold–Jarisch reflex, and the importance of recognizing that it signifies an underlying pathologic insult, especially a life-threatening one like PE.
Keywords: Bradycardia, Bezold–Jarisch reflex, Pulmonary embolism
SUPPORTING INFORMATION
Author Contributions
Jia Wei Tan - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Jay Parekh - Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Anant Shukla - Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Jia Wei Tan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
