A CASE REPORT OF ADAMS-STOKES SYNDROME - COMPLETE ATRIOVENTRICULAR BLOCK MANIFESTED AS CARDIAC SYNCOPE
Keywords:
adams-stokes syndrome, syncope, bradicardia, complete AV block
Abstract
INTRODUCTION/OBJECTIVE Syncope is a sudden and transient loss of consciousness caused by brain hypoperfusion.Adams-Stokes syndrome is an arrhythmia manifested by cardiogenic syncope.It is diagnosed easily,by electrocardiographic recording,where a complete AV block is usually observed,often second-degree AV block with a slow ventricular response.The objective is to present a patient in whom syncope happened after physical therapy,while the cause of syncope as part of ASS,was complete AV block.CASE REPORT The patient,74 years old,states that,after getting off the bus,she felt weakness and fainting.She lost consciousness and fell and suffered a head injury.On examination,she was conscious,hypotensive,bradycardic.Electrocardiography registered complete AV block with ventricular response 24/min and complete RBBB.CONCLUSION Considering that unrecognized ASS can lead to serious complications and even sudden cardiac death,it is necessary to standardize the prehospital ECG recording in every patient who clinically presents with syncope or convulsions.
References
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8.Cioffi GM, Gasperetti A, Tersalvi G, Schiavone M, Compagnucci P, Sozzi FB, et al. Etiology and device therapy in complete atrioventricular block in pediatric and young adult population: Contemporary review and new perspectives. J Cardiovasc Electrophysiol. 2021;32(11):3082-94. doi: 10.1111/jce.15255. PMID: 34570400.
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13.Kumar K, Kumar R, Pandey M, Verma R. Stokes-Adams Syndrome as a Presenting Feature of Hypoadrenalism: A Rare Presentation. Ann Afr Med. 2024;23(3):509-11. doi: 10.4103/aam.aam_154_22. PMID: 39034582.
14.Carano N, Bo I, Tchana B, Vecchione E, Fantoni S, Agnetti A. Adams-Stokes attack as the first symptom of acute rheumatic fever: report of an adolescent case and review of the literature. Ital J Pediatr. 2012;38:61. doi: 10.1186/1824-7288-38-61. PMID: 23110777.
15.Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(7):932-87. doi: 10.1016/j.jacc.2018.10.043.
16.Hama T, Morita N, Ushijima A, Ueno A, Iida T, Ikari Y, Kobayashi Y. Impact of bedrest on cardiovascular events and complications associated with temporary pacemakers in patients waiting for permanent pacemaker implantation. J Arrhythm. 2021;37(3):669-75. doi: 10.1002/joa3.12534. PMID: 34141020.
2.Grossman SA, Badireddy M. Syncope. 2023 Jun 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 28723035.
3.Mizrachi EM, Sitammagari KK. Cardiac Syncope. 2023 Apr 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30252283.
4.Janković T, & Đorđević S. Povišen troponin kod sportiste - infarkt miokarda ili fiziološka pojava. Halo 194, 2024; 30(2), 56-60. https://doi.org/10.5937/halo30-52186.
5.Longo S, Cicalini I, Pieragostino D, De Laurenzi V, Legramante JM, Menghini R, et al. A Metabolomic Approach to Unexplained Syncope. Biomedicines. 2024 Nov 19;12(11):2641. doi: 10.3390/biomedicines12112641. PMID: 39595205.
6.Sidhu S, Marine JE. Evaluating and managing bradycardia. Trends Cardiovasc Med. 2020;30(5):265-72. doi: 10.1016/j.tcm.2019.07.001. PMID: 31311698.
7.Czapp S, Nowak K. Gerbec Morgagni Adams Stokes Syndrome. Ann Med Health Sci Res. 2022;12:1-2.
8.Cioffi GM, Gasperetti A, Tersalvi G, Schiavone M, Compagnucci P, Sozzi FB, et al. Etiology and device therapy in complete atrioventricular block in pediatric and young adult population: Contemporary review and new perspectives. J Cardiovasc Electrophysiol. 2021;32(11):3082-94. doi: 10.1111/jce.15255. PMID: 34570400.
9.Cibic, Boris, Kenda, Miran F. Prvi opis napadov sinkop (sinkopalnih napadov) pri srčnem bolniku. Zdravniški vestnik. 2005; 74(1): I-7 - I-8.
10.Sigurd B, Sandøe E. Management of Stokes-Adams syndrome. Cardiology. 1990;77(3):195-208. doi: 10.1159/000174601. PMID: 2272057.
11.Ostrander LD Jr, Brandt RL, Kjelsberg MO, Epstein FH. Electrocardiographic findings among the adult population of a total natural community, Tecumseh, Michigan. Circulation. 1965;31:888-98. doi: 10.1161/01.cir.31.6.888. PMID: 14297523.
12.Tabuzo MMB, Ty MLT, Jamora RD. Ventricular standstill disguised as epilepsy: A case report on Stokes-Adams attacks. Heliyon. 2023;9(7):e18335. doi: 10.1016/j.heliyon.2023.e18335. PMID: 37519698.
13.Kumar K, Kumar R, Pandey M, Verma R. Stokes-Adams Syndrome as a Presenting Feature of Hypoadrenalism: A Rare Presentation. Ann Afr Med. 2024;23(3):509-11. doi: 10.4103/aam.aam_154_22. PMID: 39034582.
14.Carano N, Bo I, Tchana B, Vecchione E, Fantoni S, Agnetti A. Adams-Stokes attack as the first symptom of acute rheumatic fever: report of an adolescent case and review of the literature. Ital J Pediatr. 2012;38:61. doi: 10.1186/1824-7288-38-61. PMID: 23110777.
15.Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(7):932-87. doi: 10.1016/j.jacc.2018.10.043.
16.Hama T, Morita N, Ushijima A, Ueno A, Iida T, Ikari Y, Kobayashi Y. Impact of bedrest on cardiovascular events and complications associated with temporary pacemakers in patients waiting for permanent pacemaker implantation. J Arrhythm. 2021;37(3):669-75. doi: 10.1002/joa3.12534. PMID: 34141020.
Published
2025/10/29
Section
Case report
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