1/4. Recurrent asystoles associated with vasovagal reaction during venipuncture.A 17-year-old high school student presented with a history of habitual faintings. On 24-hour Holter monitoring, cardiac asystoles were recorded, the longest lasting approximately 7 or 8 seconds during venipuncture procedures. The asystole associated with venipuncture demonstrated the cardioinhibitory effects of vasovagal reaction with blood-injury phobia. He also had a positive response during head-up tilt test showing hypotension and relative bradycardia after intravenous isoproterenol injection. After administration of oral beta blocker, he did not show further or recurrent cardiac asystole during blood injury procedure on electrocardiographic examination. Venipuncture is the most common invasive medical procedure performed in hospital settings. While venipuncture is considered to be reasonably safe, serious complication may occur even when only a small volume of blood is withdrawn. Therefore, medical personnel should be prepared to provide appropriate care.- - - - - - - - - - ranking = 1keywords = venipuncture (Clic here for more details about this article) |
2/4. Neurocardiogenic syncope in a 10-year-old boy.We present a case with a suspected epileptic disorder. This may be a result of a neurocardiogenic syncope leading to seizures. A 10-year-old boy suffered two episodes of sudden loss of consciousness after getting injections. electrocardiography (ECG) and electroencephalography recordings during a venipuncture showed asystole of 6 seconds followed by a generalized seizure with clonic jerks of the right arm and leg while theta waves in the EEG were noted. Tilt-table testing could not provoke a pathological reaction.- - - - - - - - - - ranking = 0.14285714285714keywords = venipuncture (Clic here for more details about this article) |
3/4. Sudden fatal cardiac arrest in a child with an unrecognized anterior mediastinal mass.We report a case of sudden fatal cardiac arrest in a 3-year-old boy. The arrest occurred when he was placed in the supine position by force for a venipuncture. autopsy revealed a large anterior mediastinal mass. The death was attributed to the airway obstruction and cardiac compression by the mass. Postural change to supine position by force was believed to have triggered compression of the cardiopulmonary system by an unrecognized anterior mediastinal mass, resulting in cardiac arrest.- - - - - - - - - - ranking = 0.14285714285714keywords = venipuncture (Clic here for more details about this article) |
4/4. Recurrent asystole associated with vasovagal reaction during venipuncture.A patient with a documented history of 2 asystolic episodes associated with venipuncture demonstrates the profound cardioinhibitory effects that vasovagal reactions to blood and injury ("blood-injury phobia") can produce. In approaching a patient with blood-injury phobia, the clinician should place the patient in the Trendelenburg position, apply a cardiac monitor, administer oxygen, and consider the need for atropine, transcutaneous pacing, and cough cardiopulmonary resuscitation (CPR) prior to venipuncture. diagnosis of vasovagal syncope is discussed. Long-term prophylactic interventions may be beneficial for certain patients.- - - - - - - - - - ranking = 0.85714285714286keywords = venipuncture (Clic here for more details about this article) |