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- Ian S deSouza and Monisha Dilip.
- Department of Emergency Medicine, SUNY Downstate Medical Center, Kings County Hospital Center, Brooklyn, New York.
- J Emerg Med. 2019 Jul 1; 57 (1): e9-e12.
BackgroundVagally mediated atrioventricular block (AVB) may occur as a result of increased parasympathetic tone. This particular AVB is infrequently described in the literature, but its prevalence may be underestimated, as it may occur without recognition.Case ReportWe present a case of vagally mediated AVB that was identified by serial electrocardiography of a patient who presented to the emergency department with vomiting. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Vagally mediated AVB must be differentiated from paroxysmal, bradycardia-dependent AVB, which may progress to persistent AVB and require pacemaker placement. In an asymptomatic patient with vagally mediated AVB, pacemaker placement is contraindicated. However, if symptoms are clearly attributable to vagally mediated AVB, pacemaker placement may be reasonable.Copyright © 2019 Elsevier Inc. All rights reserved.
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