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Stokes-Adams Attacks

Thomas Beyerle, MEng, MD and Joshua Ean Bellamy, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Sudden transient loss of consciousness due to decreased cardiac output causing cerebral hypoxia in patients with bradyarrhythmias secondary to advanced heart block and sick sinus syn...

DIAGNOSIS

HISTORY

  • History of predisposing factor/related conditions

  • Chest pain

  • Light-headedness, dizziness

  • Fatigue/exercise intolerance

  • Shortness of breath/orthopnea/paroxysmal nocturnal dyspnea

  • Altered sen...

TREATMENT

GENERAL MEASURES

  • Inpatient assessment with cardiac monitoring

  • Continued treatment for prevention of future episodes in an ambulatory setting

  • Cessation of precipitating medications

  • Pacemaker impl...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Routine follow-up with cardiologist 

Patient Monitoring

  • Routine pacemaker check if permanent pacemaker has been implanted

  • Follow-up Holter and/or event monitoring fo...

REFERENCES

1
Kerns W 2nd, Kline J, Ford MD. Beta-blocker and calcium channel blocker toxicity. Emerg Med Clin North Am. 1994;12(2):365–390.
2
Tomassoni  AJ, Sanders  S, Marcolini  ...

CODES

ICD10

I45.9 Conduction disorder, unspecified 

SNOMED

  • 271547004 Stokes-Adams attack (disorder)

  • 46935006 Stokes-Adams syndrome (disorder)

CLINICAL PEARLS

  • Stokes-Adams attacks are usually caused by decreased blood flow to the brain due to acute hypotension and/or significant changes in heart rate.

  • Syncope due to Stokes-Adams attacks frequ...

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