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Stokes-Adams Attacks

Abhishek Thandra, MBBS and Pallavi Bellamkonda, MBBS Reviewed 06/2018
 


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
Díaz-Castro O, Orizaola P, Vázquez S, et al. Images in cardiovascular medicine. “Stokes-Adams epilepsy”: sometimes we need the electroencephalogram. Circulation.  2005;112(8):e101–e10...

ADDITIONAL READING

  • Bedford Laboratories. Ephedrine Sulfate Injection. USP (50 mg/mL) Prescribing Information. Bedford, OH: Bedford Laboratories; 1998.

  • Elizari MV, Acunzo RS, Ferreiro M. Hemiblocks re...

CODES

ICD10

I45.9 Conduction disorder, unspecified 

ICD9

426.9 Conduction disorder, unspecified 

SNOMED

  • 271547004 Stokes-Adams attack (disorder)

  • 46935006 Stokes-Adams syndrome (disorder)

CLINICAL PEARLS

  • Syncope due to Stokes-Adams attacks frequently can be confused for epilepsy.

  • Stokes-Adams attacks usually require insertion of a pacemaker for definitive treatment unless due to a rever...

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