title: A Heart Stopping Case of the Bezold-Jarisch Reflex.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Centre Hospitalier Universitaire de Sherbrooke, 3001 12 Avenue, Fleurimont, QC, Canada J1H 5N4.
authors.forename: Marc-Etienne
authors.identifier: 0000-0001-8015-1981
authors.initials: ME
authors.lastname: Parent
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire de Sherbrooke, 3001 12 Avenue, Fleurimont, QC, Canada J1H 5N4.
authors.forename: Serge
authors.identifier: 0000-0002-4242-9740
authors.initials: S
authors.lastname: Lepage