Bronchoscopy-induced fatal asystole in tetanus: the result of combined carotid-body chemoreceptor and vasovagal reflexes.
A 44-year-old man with tetanus had bradycardia with hypotension and then died suddenly when asystole developed during bronchoscopy. Although signs and symptoms of sympathetic hyperactivity are characteristic of tetanus, vagal stimulation via vasovagal and carotid-body chemoreceptor reflexes may produce sudden, unexpected, and catastrophic effects.
Department of Neurology, West Virginia University School of Medicine, Morgantown 26506.
J E
JE
Riggs
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D001919:Bradycardia / Q000209:etiology / Q000503:physiopathology; D001999:Bronchoscopy / Q000009:adverse effects*; D002344:Carotid Body / Q000503:physiopathology*; D006323:Heart Arrest / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D008297:Male; D010400:Penicillin G / Q000627:therapeutic use; D012018:Reflex / Q000502:physiology*; D013742:Tetanus / Q000150:complications / Q000503:physiopathology*; D013743:Tetanus Antitoxin / Q000627:therapeutic use; D014630:Vagus Nerve / Q000503:physiopathology*
D013743:Tetanus Antitoxin; D010400:Penicillin G