Atrioventricular block secondary to straining.
Cardiac arrest while straining during a bowel movement is not unusual in elderly patients. Sinus bradycardia caused by increased vagal tone can lead to severe myocardial and cerebral hypoperfusion with cardiac arrest. We describe a female postoperative patient who, while straining on a bedside commode, developed varying degrees of atrioventricular heart block, necessitating placement of a permanent pacemaker.
D000368:Aged; D003672:Defecation; D005260:Female; D006327:Heart Block / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008531:Megacolon / Q000150:complications*; D010138:Pacemaker, Artificial; D013312:Stress, Physiological / Q000150:complications*