A Heart Stopping Case of the Bezold-Jarisch Reflex

Abstract EN

The Bezold-Jarisch reflex is a parasympathetic reflex induced by intense mechanical stimulation of the ventricular myocytes.

Exceptionally, cases have been described in patients receiving dobutamine infusion during a stress echocardiography.

All were healthy middle-aged women and recovered without sequelae.

A healthy 60-year-old woman suffered two 5.9-second episodes of asystole during her 20 mcg/kg/min infusion of dobutamine.

Recovery was quick and without sequelae.

Echocardiography and coronary angiography were both normal.

In conclusion, this is the fourth documented case of a severe Bezold-Jarisch reflex causing asystole during dobutamine infusion.

Diagnosis can only be made after excluding all other possible diagnoses, most importantly ischemia.

This serves as a reminder of the importance of close monitoring during dobutamine infusion.