ACUTE IDIOPATHIC GASTRIC DISTENSION CAUSING ATRIOVENTRICULAR BLOCK AND CARDIOGENIC SHOCK

摘要

Background: We report a rare case of acute idiopathic gastric dilatation with associated severe bradycardia and shock. Case Report: A 69-year-old woman presented to the emergency department (ED) with complaint of chest pain and dyspnea. The patient required transvenous cardiac pacing for profound bradycardia and cardiogenic shock. After a negative emergent cardiac catheterization, a flat plate abdominal x-ray study demonstrated massive gastric dilatation, prompting nasogastric tube placement, with subsequent rapid improvement of the patient's cardiovascular and metabolic instability. Why Should an Emergency Physician Be Aware of This?: This case highlights the rare though potentially catastrophic complications of acute gastric dilatation, and benefits of early intervention with gastric decompression. (C) 2017 Elsevier Inc. All rights reserved.