Malignant vagotonia due to selective baroreflex failure.

Jordan J, Shannon JR, Black BK, Costa F, Ertl AC, Furlan R, Biaggioni I, Robertson D
Hypertension. 1997 30 (5): 1072-7

PMID: 9369258 · DOI:10.1161/01.hyp.30.5.1072

Baroreflex failure is characterized by dramatic fluctuations of sympathetic activity and paroxysms of hypertension and tachycardia. In contrast, unopposed parasympathetic activity has not been described in patients with baroreflex failure because of concurrent parasympathetic denervation of the heart. We describe the unusual case of a patient with baroreflex failure in a setting of preserved parasympathetic control of HR manifesting episodes of severe bradycardia and asystole. Thus, parasympathetic control of the HR may be intact in occasional patients with baroreflex failure. Patients with this selective baroreflex failure require a unique therapeutic strategy for the control of disease manifestations.

MeSH Terms (16)

Baroreflex Blood Pressure Bradycardia Female Head-Down Tilt Heart Rate Humans Hypotension Middle Aged Nervous System Diseases Norepinephrine Parasympathetic Nervous System Stimulation, Chemical Supine Position Vagus Nerve Valsalva Maneuver

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