STOKES ADAMS SYNDROME

DEFINITION OF STOKES ADAMS SYNDROME

It is a condition of complete ventricular asystole or standstill in a case of partial heart block which has been transformed to complete heart block but the idioventricular rhythm has not been established or the rate is very slow (15-20 per minute) or another block develops within (block within block). It may also occur in Mobitz type II or SA block
It is a complication of complete heart block and the clinical features are due to cerebral ischaemia.

SYMPTOMS

These develop in this order:
Headache and Giddiness–3 seconds
Fainting attacks–6 seconds
Unconsciousness –9 seconds.
Convulsion-12 seconds.
If asystole is prolonged for more than 2 mins death becomes inevitable. In some patients the asystole does not last long to cause syncope but there is a feeling as if patient is going to faint. Sometimes there is dizziness but no true vertigo. From this state quick recovery occurs. This is called “Near syncope.STOKES-ADAMS SYNDROME

SINGS

Pulse-usually absent or very slow 10-20/minutes.
Respiration-continues and hurried.
Skin-pale and cyanosis appears. When the attack subsides a characteristic flush appears and convulsion may occur once again.
MANAGEMENT
If facilities are available immediate artificial transvenous or transventricular pacemaker should be implanted. During intermittent A-V block demand pace-maker is better.
STOKES ADAMS SYNDROME
DEFINITION
It is a condition of complete ventricular asystole or standstill in a case of partial heart block which has been transformed to complete heart block but the idioventricular rhythm has not been established or the rate is very slow (15-20 per minute) or another block develops within (block within block). It may also occur in Mobitz type II or SA block
It is a complication of complete heart block and the clinical features are due to cerebral ischaemia. STOKES-ADAMS SYNDROME

SYMPTOMS
These develop in this order:
Headache and Giddiness–3 seconds
Fainting attacks–6 seconds
Unconsciousness –9 seconds.
Convulsion-12 seconds.
If asystole is prolonged for more than 2 mins death becomes inevitable. In some patients the asystole does not last long to cause syncope but there is a feeling as if patient is going to faint. Sometimes there is dizziness but no true vertigo. From this state quick recovery occurs. This is called “Near syncope. STOKES-ADAMS SYNDROME

SINGS
Pulse-usually absent or very slow 10-20/minutes.
Respiration-continues and hurried.
Skin-pale and cyanosis appears. When the attack subsides a characteristic flush appears and convulsion may occur once again.
MANAGEMENT
If facilities are available immediate artificial transvenous or transventricular pacemaker should be implanted. During intermittent A-V block demand pace-maker is better.

STOKES ADAMS SYNDROME

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