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==Overview==
==Overview==

Revision as of 16:45, 19 November 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Rim Halaby, M.D. [3]; Mugilan Poongkunran M.B.B.S [4]

Overview

Bezold-Jarisch reflex is the occurrence of bradycardia and hypotension through a pathway involving cardiac receptors,medullary centers and vagal afferent nerves.[1] It results from cardiovascular depressor reflex involving a marked increase in vagal efferent discharge to the heart, elicited by stimulation of mechanoreceptors, primarily in theleft ventricle. This leads to bradycardia and dilatation of the peripheral blood vessels with resulting lowering of the blood pressure. [2] [3] [4] Bezold-Jarisch reflex is responsible for 61% of bradyarrhythmia that occur within the first 60 minutes of inferoposterior myocardial infarction.[5] In addition, it is considered a good prognostic indicator of successful early reperfusion and coronary artery patency in the setting of thrombolysis after inferoposterior MI.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Aortic stenosis, arrhythmias, Bradbury-Eggleston syndrome,carotid sinus hypersensitivity, chronic heart failure, coronary catheterization, coronary reperfusion, digitalis,excessive bleeding, hypertrophic cardiomyopathy, inferior wall myocardial infarction,myocarditis, pericarditis, prinzmetal's angina, radiofrequency catheter ablation, temporary cardiac pacing, vasovagal syncope
Chemical/Poisoning Food poisoning, grayanotoxin-contaminated honey
Dental No underlying causes
Dermatologic Excessive sweating
Drug Side Effect ACE inhibitor, acetophenazine, adriamycin, aliskiren (direct renin inhibitor), alpha blockers, ARB, BNP, calcium channel blocker, cannabinoid, central 3-amino-1,2,4-triazole(ATZ), clonidine,codeine withdrawal, colchicine toxicity, deoxycorticosterone acetate, digitalis, dihydrocapsaicin,disulfiram toxicity, dobutamine, ketanserin, L-S-nitrosocysteine, MAO inhibitors, mibefradil, nandrolone,nitrates, sodium nitroprusside, ondansetron, phenylbiguanide, pramipexole, prazosin,prostacyclin(PGI2), serotonin receptor agonist, systemic cholecystokinin, tamsulosin,thiazole derivatives, tricyclic antidepressants, zotepine
Ear Nose Throat Wolfram's disease
Endocrine Acute pancreatitis, addisonian crisis, Addison's disease, congenital adrenal hyperplasia due to 21-hydroxylase deficiency, congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency, diabetes insipidus,diabetes mellitus type 2, diabetic ketoacidosis, hyperosmolar non-ketotic diabetic coma, multiple endocrine neoplasia, panhypopituitarism, pheochromocytoma, pseudohypoaldosteronism type 1, Waterhouse-Friederichsen syndrome,Wolfram's disease, X-Linked congemital adrenal hyperplasia
Environmental Dihydrocapsaicin, excessive sweating, grayanotoxin-contaminated honey, heat stroke,malnutrition, marijuana, veratridine
Gastroenterologic Acute pancreatitis, diarrhea, dysentery, food poisoning, hyperemesis gravidarum, vomiting
Genetic Congenital adrenal hyperplasia due to 21-hydroxylase deficiency, congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency, cystinosis, familial dysautonomia, Fanconi syndrome, multiple endocrine neoplasia, pseudohypoaldosteronism type 1, Riley-Day syndrome, Shy-Drager syndrome,Wolfram's disease, X-Linked congenital adrenal hyperplasia
Hematologic No underlying causes
Iatrogenic Coronary catheterization, coronary reperfusion, dialysis, high spinal blockade,interscalene brachial plexus block, pyrexia, radiofrequency catheter ablation, severe dehydration,surgery in prone position, temporary cardiac pacing, vomiting, whole-body acute irradiation
Infectious Disease Dysentery, endotoxins, Guillain-Barre syndrome, HIV/AIDS, pyrexia
Musculoskeletal/Orthopedic No underlying causes
Neurologic Bradbury-Eggleston syndrome, cannabinoid, dementia with Lewy bodies, familial dysautonomia, Guillain-Barre syndrome, panhypopituitarism, paraneoplastic autonomic neuropathy,parkinson's disease, Riley-Day syndrome, Shy-Drager syndrome, vasovagal syncope, veratridine
Nutritional/Metabolic Anorexia nervosa, vitamin B12 deficiency
Obstetric/Gynecologic Hyperemesis gravidarum
Oncologic Paraneoplastic autonomic neuropathy
Ophthalmologic No underlying causes
Overdose/Toxicity Cocaine overdose, colchicine toxicity, disulfiram toxicity, marijuana
Psychiatric Anorexia nervosa
Pulmonary No underlying causes
Renal/Electrolyte Cystinosis, dialysis, Fanconi syndrome, renal failure
Rheumatology/Immunology/Allergy Anaphylaxis
Sexual Congenital adrenal hyperplasia due to 21-hydroxylase deficiency, congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency
Trauma Excessive bleeding, interscalene brachial plexus block
Urologic No underlying causes
Miscellaneous Aging, excessive dieting, excessive sweating, exercise training,prolonged upright posture, severe dehydration

Causes by Organ System developed by WikiDoc.org, Copyleft 2013

Causes in Alphabetical Order

References

  1. Aviado DM, Guevara Aviado D (2001). "The Bezold-Jarisch reflex. A historical perspective of cardiopulmonary reflexes". Ann N Y Acad Sci. 940: 48–58. PMID 11458703.
  2. A. von Bezold, Ludwig Hirt (1844-1907): Über die physiologischen Wirkungen des essigsauren Veratrine. Untersuchungen aus dem Physiologischen Laboratorium in Würzburg, 1867, 1: 73-122.
  3. A. Jarisch, C. Henze Über Blutdrucksenkung durch chemische Erregung depressorischer Nerven. Naunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie, 1937, 187: 706­-730.
  4. A. Jarisch Vom Herzen ausgehende Kreislaufreflexe. Archiv für Kreislaufforschung 1940, 7: 260-­274.
  5. Goldman, Lee; Anderson, Jeffrey L. "ST SEGMENT ELEVATION ACUTE MYOCARDIAL INFARCTION AND COMPLICATIONS OF MYOCARDIAL INFARCTION". Goldman: Goldman's Cecil Medicine (24th ed.). Saunders, an imprint of Elsevier Inc. p. 444. ISBN 978-1-4377-1604-7.
  6. Mark AL (1983). "The Bezold-Jarisch reflex revisited: clinical implications of inhibitory reflexes originating in the heart". J Am Coll Cardiol. 1 (1): 90–102. PMID 6826948.


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