Postexertional Cardiac Asystole in a Young Man Without Organic Heart Disease
Authors: EDWARD C. HUYCKE
Journal: Annals of Internal Medicine (1987)

Brief Reports1 June 1987Postexertional Cardiac Asystole in a Young Man Without Organic Heart DiseaseEDWARD C. HUYCKE, M.D., HAROLD G. CARD, M.D., SAMUEL M. SOBOL, M.D., NGAI X. NGUYEN, M.D., RUEY J. SUNG, M.D.EDWARD C. HUYCKE, M.D.Search for more papers by this author, HAROLD G. CARD, M.D.Search for more papers by this author, SAMUEL M. SOBOL, M.D.Search for more papers by this author, NGAI X. NGUYEN, M.D.Search for more papers by this author, RUEY J. SUNG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-6-844 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHypotension and syncope are common in erect subjects after exhaustive exercise of short duration (1, 2). Persistent postexercise peripheral arterial vasodilitation coupled with impaired venous return have been implicated as mediating events (3). Sinus pause with ventricular asystole is an unusual cause of postexercise syncope and has been ascribed to an excessive vagal response (4-7). We report a case of reproducible postexertional sinus pause with ventricular asystole and syncope and assess the effects of vagolytic and beta-adrenergic blocking agents.A previously healthy 22-year-old man had a syncopal episode several seconds after maximal exertion pedaling a bicycle up-hill. Results of physical...Reference1. FLEG J and LAKATTA E. Prevalence and significance of postexercise hypotension in apparently healthy subjects. Am J Cardiol. 1986;57:1380-4. CrossrefMedlineGoogle Scholar2. EICHNA L, HORVATH S, and BEAN W. Post-exertional orthostatic hypotension. Am J Med Sci. 1947;213:641-54. CrossrefMedlineGoogle Scholar3. BJURSTEDT H, ROSENHAMER G, BALLDIN U, and KATKOV V. Orthostatic reactions during recovery from exhaustive exercise of short duration. Acta Physiol Scand. 1983;119:25-31. CrossrefMedlineGoogle Scholar4. EICHNA L, HORVATH S, and BEAN W. Cardiac asystole in a normal young man following physical effort. Am Heart J. 1947;33:254-62. CrossrefMedlineGoogle Scholar5. SCHLESINGER Z. Life-threatening "vagal reaction" to physical fitness test [Letter]. JAMA. 1973;226:1119. CrossrefMedlineGoogle Scholar6. FLEG J and ASANTE A. Asystole following treadmill exercise in a man without organic heart disease. Arch Intern Med. 1983;143:1821-2. CrossrefMedlineGoogle Scholar7. PINELLI G, ALBERICI S, MANINI G, DI PASQUALE G, LEONARDI G, and STEFANINI A. Episodi sincopali in giovani athleti sani: presentazione di 3 casi in corso di valutazione ergometrica. G Ital Cardiol. 1982;12:445-8. MedlineGoogle Scholar8. BRUCE R and HORNSTEN T. Exercise stress testing in the evaluation of patients with ischemic heart disease. Prog Cardiovasc Dis. 1969;11:371-90. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: EDWARD C. HUYCKE, M.D.; HAROLD G. CARD, M.D.; SAMUEL M. SOBOL, M.D.; NGAI X. NGUYEN, M.D.; RUEY J. SUNG, M.D.Affiliations: Letterman Army Medical Center and University of California San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBlood pressure regulation X: what happens when the muscle pump is lost? 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