Adams-Stokes syndrome


Adams-Stokes syndrome

Infobox_Disease
Name = PAGENAME


Caption =
DiseasesDB = 12443
ICD10 = ICD10|I|45|9|i|30
ICD9 = ICD9|426.9
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj =
eMedicineTopic =
MeshID = D000219
The term Stokes-Adams Attack refers to a sudden, transient episode of syncope, occasionally featuring seizures. It is named after two Irish physicians, [WhoNamedIt|synd|1158] Robert Adams (1791–1875) [R. Adams. Cases of Diseases of the Heart, Accompanied with Pathological Observations. Dublin Hospital Reports, 1827, 4: 353-453. ] and William Stokes (1804–1877). [W. Stokes. Observations on some cases of permanently slow pulse. Dublin Quarterly Journal of Medical Science, 1846, 2: 73-85.]

igns and symptoms

Prior to an attack, a patient may become pale, their heart rhythm experiences a temporary pause, and collapse may follow. Normal periods of unconsciousness last approximately thirty seconds; if seizures are present, they will consist of twitching after 15–20 seconds. Breathing continues normally throughout the attack, and so on recovery the patient becomes flushed as the heart rapidly pumps the oxygenated blood from the pulmonary beds into a systemic circulation which has become dilated due to hypoxia.cite book|last = Katz | first = Jason| authorlink = | coauthors = Patel, Chetan| title = Parkland Manual of Inpatient Medicine| publisher = FA Davis| date = 2006| location = Dallas, TX| pages = 903|]

As with any syncopal episode that results from a cardiac dysrhythmia, the faints do not depend on the patient's position. If they occur during sleep, the presenting symptom may simply be feeling hot and flushed on waking.

Diagnosis

Stokes-Adams attacks may be diagnosed from the history, with paleness prior to the attack and flushing after it particularly characteristic. The ECG will show asystole or ventricular fibrillation during the attacks.

Causes

The attacks are caused by loss of cardiac output due to cardiac asystole, heart block, or ventricular fibrillation. The resulting lack of blood flow to the brain is responsible for the faint.

Treatment

Initial treatment can be medical, involving the use of drugs like isoproterenol (Isuprel) and epinephrine (adrenaline). Definitive treatment is surgical, involving the insertion of a pacemaker – most likely one with sequential pacing such as a DDI mode as opposed to the older VVI mechanisms.

Prognosis

If undiagnosed (or untreated), Stokes-Adams attacks have a 50% mortality within a year of the first episode. The prognosis following treatment is very good.

References


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Look at other dictionaries:

  • Adams-Stokes syndrome — n STOKES ADAMS SYNDROME * * * see Stokes Adams syndrome * * * episodic cardiac arrest and syncope due to failure of normal and escape pacemakers, with or without ventricular fibrillation; it is the principal clinical manifestation of severe heart …   Medical dictionary

  • Adams-Stokes syndrome — noun recurrent sudden attacks of unconsciousness caused by impaired conduction of the impulse that regulates the heartbeat • Syn: ↑heart block, ↑Stokes Adams syndrome, ↑atrioventricular block • Hypernyms: ↑cardiac arrhythmia, ↑arrhythmia * * *… …   Useful english dictionary

  • Adams-Stokes syndrome — /ad euhmz stohks / Pathol. See Stokes Adams syndrome. Also called Adams Stokes disease. * * * …   Universalium

  • Adams-Stokes syndrome — see Stokes Adams syndrome …   The new mediacal dictionary

  • Morgagni-Adams-Stokes syndrome — Mor·ga·gni Ad·ams Stokes syndrome (mor gahґnye adґəmz stōksґ) [G.B. Morgagni; Robert Adams, Irish physician, 1791–1875; William Stokes, Irish physician, 1804–1878] Adams Stokes syndrome; see under syndrome …   Medical dictionary

  • Morgagni-Adams-Stokes syndrome — Adams Stokes s …   Medical dictionary

  • Adams-Stokes attack — n STOKES ADAMS SYNDROME R. Adams see STOKES ADAMS SYNDROME J. Stokes see CHEYNE STOKES RESPIRATION * * * an episode of syncope in Adams Stokes syndrome …   Medical dictionary

  • Stokes-Adams attack syndrome (syncope) — Stokes Ad·ams attack, syndrome (syncope) (stōksґ adґəmz) [W. Stokes; Robert Adams, Irish physician, 1791–1875] see Adams Stokes attack, under attack and Adams Stokes syndrome, under syndrome …   Medical dictionary

  • Adams-Stokes-Anfall — Klassifikation nach ICD 10 I45.9 Kardiale Erregungsleitungsstörung, nicht näher bezeichnet …   Deutsch Wikipedia

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