Adams–Stokes syndrome

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Stokes-Adams syndrome
Other namesAdams–Stokes syndrome, Gerbezius–Morgagni–Adams–Stokes syndrome and Gerbec–Morgagni–Adams–Stokes syndrome[1]
SpecialtyCardiology Edit this on Wikidata

Adams–Stokes syndrome, Stokes–Adams syndrome or Gerbec–Morgagni–Adams–Stokes syndrome is a periodic

complete heart block
.

Signs and symptoms

Typically an attack occurs without warning, leading to sudden

loss of consciousness.[4] Prior to an attack, a patient may be pale with hypoperfusion. Abnormal movements may be present, typically consisting of twitching after 15–20 seconds of unconsciousness. (These movements, which are not seizures, occur because of brainstem hypoxia and not due to cortical discharge as is the case for epileptiform seizures). Breathing typically continues normally throughout the attack, and, upon recovery, the patient becomes flushed as the heart rapidly pumps the oxygenated blood from the pulmonary beds into the systemic circulation, which has become dilated due to hypoxia.[5]

As with any syncopal episode that results from a cardiac dysrhythmia, the fainting does not depend on the patient's position. If it occurs during sleep, the presenting symptom may simply be feeling hot and flushed on waking.[5][6]

Causes

The attacks are caused by any temporary lack of cardiac output caused by a transient abnormal heart rhythm. Paroxysmal supraventricular tachycardia or atrial fibrillation has been reported as the underlying cause in up to 5% of patients in one series. The resulting lack of blood flow to the brain is responsible for the loss of consciousness and associated fainting episode.[7]

Diagnosis

Stokes–Adams attacks may be diagnosed from the

Torsades de Pointes can occur in a heart block setting.[8]

Treatment

Initial treatment can be medical, involving the use of drugs like

pacemaker.[9]

Prognosis

If undiagnosed (or untreated), Stokes–Adams attacks have a 50% mortality within a year of the first episode. The prognosis following treatment is very good.[citation needed]

References

  1. Who Named It?
  2. ^ R. Adams. Cases of Diseases of the Heart, Accompanied with Pathological Observations. Dublin Hospital Reports, 1827, 4: 353–453.
  3. ^ W. Stokes. Observations on some cases of permanently slow pulse. Dublin Quarterly Journal of Medical Science, 1846, 2: 73–85.
  4. ^ "Stokes-Adams; Adams-Stokes; Morgagni-Adams-Stokes Attacks". patient.info. 18 October 2021.
  5. ^ a b Katz, Jason; Patel, Chetan (2006). Parkland Manual of Inpatient Medicine. Dallas, TX: FA Davis. p. 903.
  6. ^ ADams and victor's principles of neurology
  7. ^ "Stokes-Adams Attacks (Causes, Symptoms, and Treatment)". 18 October 2021.
  8. ^ Khan, Ijaz A. (13 November 2021). "Mechanisms of syncope and Stokes-Adams attacks in bradyarrhythmia: Asystole and torsade de pointes".
  9. ISBN 0-86318-864-8

External links

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