Acute Idiopathic Gastric Distension Causing Atrioventricular Block and Cardiogenic Shock

Publication date: Available online 8 June 2017
Source:The Journal of Emergency Medicine
Author(s): Ryan Stringer, Megan Schrader
BackgroundWe report a rare case of acute idiopathic gastric dilatation with associated severe bradycardia and shock.Case ReportA 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.



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