Vaso-Vagal Discussion

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vaso-vagal resulting in asystole?

From: Jim Etheridge

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I was just released from the hospital yesterday. Last Mon. I went to the top of Pikes Peak (14,110') and felt a crushing, squeezing chest pain never before experienced (I'm a 51 year old male with no cardiac hx.). The episode lasted about 4 hours and subsided. Then Thurs. the same pain occurred as i was sweeping the church parking lot. My wife noticed my ashen color and recommended I go home and lay down; this I did but the pain did not subside. The next morning I went to my Family Dr. who said he felt I was having a heart attack. The EKG showed 1-2mm. elevation of the ST segment in the anterior leads, the T waves were inverted in Lead II and three shots of sublingual NTG and O2 seemed to help the pain. No syncopal episodes. I was admitted to the local hospital and a cardiac catheterization performed. All coronary ateries were perfectly clear! A repeat EKG showed "non-specific changes." As I was about to be released, the nurse wanted to change the dressing over the femoral artery wound site (which was dry). At this point, I was sitting on the side of the bed and felt dizzy and nauseous; my wife said "He's not doing good" and I passed out. They had telemtery still hooked up to me showing a change from normal sinus rhythm to a slowing junctional beat, then ASYSTOLE for 4-5 seconds! I was apneic, pulseless, showing asystole on the monitor and they called a "Code Blue." 30 people ran into the room and 1/2 amp of Atropine was administered (you can't shock asystole). A normal sinus rhythm ensued and I awoke 10 minutes later. They said it was "vaso-vagal;" since when does vaso-vagal cause ASYSTOLE!? Has that ever been documented before? The following night in the hospital at 3 am. while sound asleep, my rhythm slowed to a sinus bradycardia they recorded at a rate of 30!!! Vaso-vagal while sleeping? And lying down? What do you think -- the Drs. here are guessing. My background is Pre-Med and I was a Fire Dept. Paramedic for years -- never seen anything like this though I saw and induced many a vaso-vagal manuever in the field. HELP! Jim.


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Last changed: June 22, 2007