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{{Infobox_Disease
__NOTOC__
| Name          = {{PAGENAME}}
'''For patient information, click [[Adams-Stokes syndrome (patient information)|here]]'''
| Image          =
{{Adams-Stokes syndrome}}
| Caption        =
{{CMG}} {{AE}}
| DiseasesDB    = 12443
| ICD10          = {{ICD10|I|45|9|i|30}}
| ICD9          = {{ICD9|426.9}}
| ICDO          =
| OMIM          =
| MedlinePlus    =
| eMedicineSubj  =
| eMedicineTopic =
| MeshID        = D000219}}


{{Adams-Stokes syndrome}}
{{SK}} Morgagni-Adams-Stokes syndrome; Stokes-Adams attack


{{CMG}}
== [[Adams-Stokes syndrome overview|Overview]] ==


'''''Synonyms and key words:''''' Morgagni-Adams-Stokes syndrome or Stokes-Adams Attack
== [[Adams-Stokes syndrome historical perspective|Historical Perspective]] ==


== Overview ==
== [[Adams-Stokes syndrome pathophysiology|Pathophysiology]] ==


This refers to a sudden, transient episode of [[syncope]], occasionally featuring [[seizure]]s. It is named after two Irish physicians,<ref>{{WhoNamedIt|synd|1158}}</ref> [[Robert Adams (physician)|Robert Adams]] (1791&ndash;1875)<ref>R. Adams. Cases of Diseases of the Heart, Accompanied with Pathological Observations. Dublin Hospital Reports, 1827, 4: 353-453. </ref> and [[William Stokes]] (1804&ndash;1877).<ref>W. Stokes. Observations on some cases of permanently slow pulse. Dublin Quarterly Journal of Medical Science, 1846, 2: 73-85.</ref>
== [[Adams-Stokes syndrome causes|Causes]] ==


== Pathophysiology ==
== [[Adams-Stokes syndrome differential diagnosis|Differentiating Adams-Stokes syndrome from other Diseases]] ==


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 [[syncope]].
== [[Adams-Stokes syndrome epidemiology and demographics|Epidemiology and Demographics]] ==


== Signs and symptoms ==
== [[Adams-Stokes syndrome risk factors|Risk Factors]] ==


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&ndash;20 seconds. [[Respiratory system|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 circulation|pulmonary beds]] into a systemic circulation which has become dilated due to hypoxia.<ref name="Parkland">{{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|}}</ref>
== [[Adams-Stokes syndrome screening|Screening]] ==


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.<ref name="Parkland"/>
== [[Adams-Stokes syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==


== Diagnosis ==
== Diagnosis ==


Stokes-Adams attacks may be diagnosed from the [[Medical history|history]], with paleness prior to the attack and flushing after it particularly characteristic. The [[Electrocardiogram|ECG]] will show asystole or [[ventricular fibrillation]] during the attacks.
[[Adams-Stokes syndrome history and symptoms|History and Symptoms]] | [[Adams-Stokes syndrome physical examination|Physical Examination]] | [[Adams-Stokes syndrome laboratory findings|Laboratory Findings]] | [[Adams-Stokes syndrome electrocardiogram|Electrocardiogram]] | [[Adams-Stokes syndrome echocardiography or ultrasound|Echocardiography or Ultrasound]]


== Treatment ==
== Treatment ==


Initial treatment can be medical, involving the use of drugs like [[isoproterenol]] ([[Isuprel]])and [[epinephrine]] ([[Adrenalin]]). Definitive treatment is [[surgery|surgical]], involving the insertion of a [[artificial pacemaker|pacemaker]] – most likely one with sequential pacing such as a DDI mode as opposed to the older VVI mechanisms. <ref name="Parkland"/>
[[Adams-Stokes syndrome medical therapy|Medical therapy]] | [[Adams-Stokes syndrome surgery|Surgery]] | [[Adams-Stokes syndrome primary prevention|Primary Prevention]] | [[Adams-Stokes syndrome secondary prevention|Secondary Prevention]] | [[Adams-Stokes syndrome cost-effectiveness of therapy|Cost Effectiveness of Therapy]] | [[Adams-Stokes syndrome future or investigational therapies|Future or Investigational Therapies]]
 
== 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 ==
==Case Studies==
{{Reflist}}
[[Adams-Stokes syndrome case study one|Case #1]]
 
[[Category:Cardiology]]
[[Category:Electrophysiology]]
[[Category:Emergency medicine]]


{{Circulatory system pathology}}
{{Circulatory system pathology}}
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{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[CME Category::Cardiology]]
[[Category:Cardiology]]
[[Category:Electrophysiology]]
[[Category:Emergency medicine]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]

Latest revision as of 13:30, 21 June 2021

For patient information, click here

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Overview

Historical Perspective

Pathophysiology

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Differentiating Adams-Stokes syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Echocardiography or Ultrasound

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Synonyms and keywords: Morgagni-Adams-Stokes syndrome; Stokes-Adams attack

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Adams-Stokes syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Echocardiography or Ultrasound

Treatment

Medical therapy | Surgery | Primary Prevention | Secondary Prevention | Cost Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

de:Adams-Stokes-Syndrom fi:Adams-Stokesin oireyhtymä


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