Unstable bradycardia induced by posterior nasal packing: a rare activation of the Trigeminocardiacreflex.
BMJ Case Rep
; 16(12)2023 Dec 19.
Article
en En
| MEDLINE
| ID: mdl-38114292
ABSTRACT
A woman in her 40s presented to the emergency department with epistaxis. Anterior nasal packing was unsuccessful in achieving haemostasis. After the exchange of devices and insertion of a posterior nasal pack, the patient developed a junctional rhythm and progressively unstable bradycardia. The rhythm and bradycardia immediately improved following the removal of the posterior nasal pack. This case describes a rare occurrence of Trigeminocardiac reflex (TCR), following an insertion of a posterior nasal pack. Only one other such case has been reported and published. This case highlights the importance of raising awareness of this rare reflex and the need for prompt removal of the triggering cause in such scenarios. TCR can induce a junctional rhythm, which progresses to unstable bradycardia and may lead to asystole in susceptible individuals. The removal of the stimulus resolves the reflex and can result in prompt resolution of the bradycardia and hypotension induced via the TCR.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Epistaxis
/
Reflejo Trigeminocardíaco
Límite:
Adult
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
BMJ Case Rep
Año:
2023
Tipo del documento:
Article
País de afiliación:
Irlanda
Pais de publicación:
Reino Unido