Acute Idiopathic Gastric Distension Causing Atrioventricular

J Emerg Med · Sep 2017

Case Reports

Acute Idiopathic Gastric Distension Causing Atrioventricular Block and Cardiogenic Shock.

We report a rare case of acute idiopathic gastric dilatation with associated severe bradycardia and shock. ⋯ A 69-year-old woman presented to the emergency department (ED) with complaint of chest pain and dyspnea. The patient required transvenous cardiac pacing for profound bradycardia and cardiogenic shock. After a negative emergent cardiac catheterization, a flat plate abdominal x-ray study demonstrated massive gastric dilatation, prompting nasogastric tube placement, with subsequent rapid improvement of the patient's cardiovascular and metabolic instability. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the rare though potentially catastrophic complications of acute gastric dilatation, and benefits of early intervention with gastric decompression.

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- Ryan Stringer and Megan Schrader.
- Lakeland Healthcare Emergency Medicine Residency, Michigan State University College of Osteopathic Medicine, St. Joseph, Michigan.
- J Emerg Med. 2017 Sep 1; 53 (3): 302-305.
BackgroundWe report a rare case of acute idiopathic gastric dilatation with associated severe bradycardia and shock.Case ReportA 69-year-old woman presented to the emergency department (ED) with complaint of chest pain and dyspnea. The patient required transvenous cardiac pacing for profound bradycardia and cardiogenic shock. After a negative emergent cardiac catheterization, a flat plate abdominal x-ray study demonstrated massive gastric dilatation, prompting nasogastric tube placement, with subsequent rapid improvement of the patient's cardiovascular and metabolic instability. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the rare though potentially catastrophic complications of acute gastric dilatation, and benefits of early intervention with gastric decompression.Copyright © 2017 Elsevier Inc. All rights reserved.

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Acute Idiopathic Gastric Distension Causing Atrioventricular Block and Cardiogenic Shock.

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