Cor Pulmonale & Sinus Bradycardia & Somnolence: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Cor Pulmonale, Sinus Bradycardia, Somnolence,

Negated

None

Unsure

None

Possible Causes

Obstructive Sleep Apnea

Neither patient exhibited daytime somnolence, although both were subsequently found to have severe obstructive sleep apnea. [ncbi.nlm.nih.gov]

bradycardia and atrioventricular block, representing in part the diving reflex response to apnea and hypoxia. 144 These bradyarrhythmias occur even in the absence of any [doi.org]

References: [14] [15] Complications Hypertension Hypoxia -induced cardiac arrhythmia Pulmonary hypertension and cor pulmonale Global respiratory insufficiency Cardiac infarction [amboss.com]

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Sleep Apnea

In epilepsy patients with risk factors (eg, obesity) or markers (eg, habitual snoring, daytime somnolence) for sleep apnea, a careful sleep history should be elicited and [ncbi.nlm.nih.gov]

In their first paper, 17 which involved a study of 15 patients with SAHS, these authors observed episodes of severe sinus bradycardia and even sinus arrests during the polysomnograph [revespcardiol.org]

Vol 8, No 3 (Autumn 2009) Introduction Cor pulmonale has a well-described association with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD [phaonlineuniv.org]

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Central Sleep Apnea

Patients with hypercapnic forms may experience daytime somnolence (sometimes called wake-time sleepiness), lethargy, and morning headache. [merckmanuals.com]

In the three presented cases, marked sinus bradycardia or AV block was followed by the simultaneous occurrence of abrupt acceleration of heart rate and the appearance of rapid [ncbi.nlm.nih.gov]

This can lead to cor pulmonale (right-sided heart failure). Call your provider if you have symptoms of this disorder. [nlm.nih.gov]

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Morbid Obesity

This can be spectacularly effective in relieving right heart failure, day-time somnolence, and pulmonary hypertension. [academic.oup.com]

Arterial oxygen tension is lower and chronic hypoxemia may lead to pulmonary hypertension and cor pulmonale. [openanesthesia.org]

[…] tachycardia and bradycardia); and fatty infiltration of the conducting and pacing systems. 4 Ischaemic heart disease is more prevalent in obese patients. [academic.oup.com]

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Ayerza Syndrome

[…] also Disorder, psychosomatic) 306.9 disorder 300.81 Somatoform disorder 300.82 atypical 300.82 severe 300.81 undifferentiated 300.82 Somnambulism 307.46 hysterical 300.13 Somnolence [theodora.com]

Validation of a method for choice of pacing mode in carotid sinus syndrome with or without sinus bradycardia. Pacing Clin Electrophysiol 1991;14:196–203. 150. [cardiologieladomiciliu.ro]

Ayerza syndrome - sclerosis of the pulmonary arteries in chronic cor pulmonale. [medical-dictionary.thefreedictionary.com]

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Digitalis Toxicity

sinus bradycardia, atrioventricular block, nonparoxysmal atrioventricular junctional tachycardia, and ventricular tachycardia. [ncbi.nlm.nih.gov]

Included in this group are advanced age, certain cardiac diseases (active ischemia, myocarditis, cardiomyopathy, cardiac amyloidosis, cor pulmonale) and a variety of metabolic [prep4usmle.com]

bradycardia Magnesium sulfate may terminate dysrhythmias, but is contraindicated in the setting of bradycardia or AV block and should be used cautiously in patients with [emedicine.medscape.com]

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Infantile Apnea

•Bradycardia follows the apnea by 1-2 sec in more than 95% of cases and is most often sinus, but on occasion it can be nodal. [slideshare.net]

B., 1968, Large tonsils and adenoids in small children with cor pulmonale, Br. Heart J. 30 :356. PubMed Google Scholar 17. Bland, J. W., Edwards, F. [link.springer.com]

pulmonale, and loss of intellectual quotient points. [emedicine.medscape.com]

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Right Bundle Branch Block

History was limited as patient was somnolent and on venturi mask. [jbclinpharm.org]

Acute inferior MI and sinus bradycardia are also present. [ecglibrary.com]

He was diagnosed with a proximal bilateral acute pulmonary embolism without acute cor pulmonale. [ncbi.nlm.nih.gov]

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Acute Atrial Infarction

Neurological examination revealed somnolence, moderate dysarthria, right internuclear ophthalmoplegia, left-limb dysmetria, and ataxic gait. [elsevier.es]

After coronary angiography, the patient had chest pain associated with hypotension, sinus bradycardia, periods of complete atrioventricular block, and one episode of ventricular [jamanetwork.com]

Pulmonale Including Pulmonary Embolism, Pericardial Effusion, Acute Pericarditis, Hypertrophic Cardiomyopathy, Central Nervous System Disorder, Myxedema, Hypothermia, Sick [play.google.com]

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Syncope

[…] reports of syncope associated with AChEIs include the following: A 77-year-old female, who had been on donepezil for more than five years, experienced syncope along with somnolence [medsafe.govt.nz]

During her hospitalization for tapering of AEDs and 24-hour EEG monitoring, the patient developed a seizure followed by sinus bradycardia and an 18-second sinus pause, resulting [ncbi.nlm.nih.gov]

Failure to recognize ECG features consistent with acute cor pulmonale in a man with new onset syncope and dyspnea resulted in death from undiagnosed pulmonary emboli. [ncbi.nlm.nih.gov]

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Atrial Fibrillation

We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. [ncbi.nlm.nih.gov]

Interestingly, after treatment of crizotinib, the patient suffered a transient QTc interval prolongation and his persistent atrial fibrillation was changed into sinus bradycardia [ncbi.nlm.nih.gov]

pulmonale Drug abuse Hyperthyroidism Pneumonia Pulmonary embolism Sleep apnea Clinical Presentation Atrial fibrillation has a wide spectrum of clinical presentations. [aafp.org]

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Cor Pulmonale

Lethargy and somnolence cleared. A rapid increase in weight occurred. Radiographically, the lung fields became clear. [pubs.rsna.org]

HEART RATES• NORMAL HEART RATE• SINUS TACHYCARDIA 16. HEART RATES• SINUS BRADYCARDIA 17. COR PULMONALE 18. [slideshare.net]

[…] lung diseases. [7] Cor Pulmonale Presentation The clinical manifestations of cor pulmonale may be nonspecific. [emedicine.medscape.com]

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Pulmonary Disorder

[…] common symptoms include anxiety, arm and shoulder pain, tenderness in the calf of the leg, erythema nodosum, swelling of the face, headache, hoarseness, joint pain, and somnolence [texaspulmonary.com]

OSA resulted in small but significant reductions in systemic hypertension (1.3 to 5.3 mm Hg).101–103 OSA has been associated with increased risk for arrhythmias (including sinus [ahajournals.org]

[…] with cor pulmonale survive longer than five years. [sleepfoundation.org]

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Carotid Sinus Syncope

Grip myotonia, weakness, temporal wasting, alopecia, cataracts, glucose intolerance, and daytime somnolence. Both bradyarrhythmia and tachyarrhythmias. [ahajournals.org]

DH Sinus bradycardia. [ajconline.org]

pulmonale, constrictive pericarditis); asthma; pertussis; cystic fibrosis; traqueobroncomalacea; gastroesophageal reflux; herpetic tracheobronchitis; influenza infection; [scielo.mec.pt]

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Cardiac Tamponade

Our patient was a 77year-old female admitted after presenting with general malaise, weakness, somnolence, altered mental status and urinary incontinence found to have CML [ncbi.nlm.nih.gov]

Currently, the most widely used applications of FUSA include the guidance and characterization of perioperative shock (acute cor pulmonale, left ventricular dysfunction, cardiac [ncbi.nlm.nih.gov]

Patient is somnolent in bed, vitals are BP 75/60, HR 62, RR 24, Temp 98.6. [ultrasoundoftheweek.com]

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Sinus Arrest

Among the common adverse effects associated with sertraline are nausea, insomnia, diarrhea, somnolence, and dizziness. [ncbi.nlm.nih.gov]

Short cases in cardiology Sinus bradycardia and multiple episodes of sinus arrest following administration of ibutilide N B Amin a, S Borzak b, S Housholder c, J E Tisdale [heart.bmj.com]

Causes include: Ischaemic heart disease Pulmonary embolus Rheumatic heart disease Myocarditis Congenital heart defects Cardiomyopathy Cor pulmonale ECG Features: A widened [fastbleep.com]

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Ondine Syndrome

[…] pCO2 and decrease in pO2 CBC: polycythemia EMG/NCV: normal Clinical (asymptomatic or insidious onset) Dyspnea: uncommon Fatigue/ lethargy Disturbed sleep Excessive daytime somnolence [mdnxs.com]

Dysautonomia progressed; the patient underwent pacemaker implantation due to severe sinus bradycardia at 6 months from discharge. [elsevier.es]

This female patient, without cor pulmonale, was a good candidate for diaphragm pacing. [ncbi.nlm.nih.gov]

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Acute Cor Pulmonale

De-compensatory stage of the respiratory and cardiac function Respiratory failure Symtoms : severe dyspnea,especially at night, headache, insomnia,inappetence, somnolence, [slideshare.net]

bradycardia rhythm with first-degree AV block and left anterior fascicular block. [emedicine.medscape.com]

In most of the reported cases, a clinical picture of subacute cor pulmonale developed. [ncbi.nlm.nih.gov]

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Restrictive Lung Disease

In 1969, 12 years after her last operation, she developed dyspnea, coryza, and somnolence. She was hospitalized with a PaO2 of 30mmHg; PaCO2 of 77mmHg and a pH of 7.28. [ncbi.nlm.nih.gov]

[…] resulted in small but significant reductions in systemic hypertension (1.3 to 5.3 mm Hg). 101–103 OSA has been associated with increased risk for arrhythmias (including sinus [circ.ahajournals.org]

We present a case of polyostotic fibrous dysplasia in a young man in whom the severe deformities of the chest wall and spine produced restrictive lung disease, cor pulmonale [ncbi.nlm.nih.gov]

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Lymphangioleiomyomatosis

Somnolence is another adverse effect that has been reported with levodopa use. [ncbi.nlm.nih.gov]

Four serious adverse events were categorized as unrelated to the use of sirolimus because they occurred when the patient was not receiving the drug: sinus bradycardia after [doi.org]

The natural history of lymphangioleiomyomatosis is of progressive airflow obstruction leading to respiratory failure and cor pulmonale.1 The rate of progression is highly [thorax.bmj.com]

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Tonsillar Hypertrophy

A 29-year-old obese man had marked tonsillar hypertrophy, somnolence, hypoxemia, and hypercapnia. [ncbi.nlm.nih.gov]

bradycardia, ventricularis hyperthrophia Last Update: 2012-04-10 Usage Frequency: 2 Quality: Slovenian Centrilobularna hipertrofija jetrnih celic se je skladala z indukcijo [mymemory.translated.net]

Arterial blood gas values, electrocardiograms and chest x-ray films were compatible with cor pulmonale. [ncbi.nlm.nih.gov]

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Narcolepsy-Cataplexy Syndrome

He developed severe daytime somnolence and cataplexy over the course of a few months. [experts.umich.edu]

Electrocardiography showed sinus bradycardia and a repeat cerebral MRI study substantially confirmed the previous findings. [hindawi.com]

Pagina 574 - Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. ‎ [books.google.ro]

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Cardiac Cirrhosis

The patient may suffer from confusion, drowsiness, somnolence and even coma. [medindia.net]

[…] rhythm with a resting heart rate 70/min Contraindicated in severe bradycardia Improves symptoms Reduces hospitalization rate Hydralazine plus nitrate ( ) ( ) If EF 40% ; [amboss.com]

pulmonale. [emedicine.medscape.com]

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Respiratory Muscle Paralysis

Patients also report anxiety, insomnia, morning headache, excessive daytime somnolence and fatigue, and poor sleep habits. [emedicine.medscape.com]

bradycardia and electrocardiographic (ECG) signs of hypokalemia (U waves in leads II, V-2, V-3, and V-4, progressive flattening of T waves and depression of ST segment) may [hkpp.org]

What is cor pulmonale? Cor pulmonale (right-sided heart failure) can occur in post-polio and in other diagnoses, such as COPD. [gbppa.org]

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Idiopathic Neonatal Atrial Flutter

Accelerated hypertension is associated with somnolence, confusion, visual disturbances, and nausea and vomiting; they are common to hypertensive encephalopathy. [quizlet.com]

Sick sinus syndrome has multiple manifestations on electrocardiogram, including sinus bradycardia, sinus arrest, sinoatrial block, and alternating patterns of bradycardia [aafp.org]

Sinus bradycardia The causes of a pathological sinus bradycardia include: Drugs (negative chronotropes): Betablockers. Calcium-channel blockers. Digoxin. Amiodarone. [patient.info]

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Hypertensive Heart Disease

The neonatal presentation usually begins a few days after birth with lethargy, somnolence, refusal to feed, vomiting, tachypnea with respiratory alkalosis, and/or seizures [orpha.net]

洞 sinus arrest洞停止 sinus bradycardia洞性徐脈 sinus node洞結節 sinus of Valsalvaバ［ヴァ］ルサルバ［ヴァ］洞 sinus rhythm洞調律 sinus tachycardia洞性頻脈 situs inversus逆位 situs solitus正位 sleep apnea syndrome [tokyo-med.ac.jp]

The most common echocardiographic diagnoses were hypertensive heart disease (43.2%), dilated cardiomyopathies (17.6%), ischemic heart diseases (9.6%), and cor pulmonale (8.8% [ncbi.nlm.nih.gov]

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Propoxyphene Intoxication

[…] similar to those of narcotic overdosage and include: respiratory depression (a decrease in respiratory rate and/or tidal volume, CheyneStokes respiration, cyanosis), extreme somnolence [home.intekom.com]

bradycardia Decreased AV node conduction (1st to 3rd degree heart block) Intraventricular conduction defects Beta-adrenergic receptor blockade Sinus bradycardia Decreased [lifeinthefastlane.com]

Drugs & Medications Propoxyphene Capsule Conditions: having thoughts of suicide alcoholism alcohol intoxication drug abuse depression Cor Pulmonale prolonged QT interval on [webmd.com]

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Pulmonary Edema

In patients who become somnolent (sleepy) or who are no longer able to breathe adequately on their own, intubation (putting a tube into the airway) and using a ventilator [emedicinehealth.com]

bradycardia (heart rate (HR) 55/min) with a first-degree heart block and no acute ST or T wave changes. [edm.bioscientifica.com]

Your doctor may need to adjust your treatment plan to help prevent cor pulmonale. You can prevent cor pulmonale by taking care of your heart and lungs. [healthline.com]

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Cardiac Dyskinesia

Also similar between groups were the most common adverse events, according to EAIR, including anxiety, somnolence, depression, headache, diarrhea, and nasopharyngitis. [neurologyadvisor.com]

Am J Cardiol 36 (1975): 281-5 Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." [drugs.com]

Echocardiographic pattern of acute cor pulmonale. Chest 1997;111:209-17. Medline 9. McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. [revespcardiol.org]

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Hypersensitivity

13 Minor adverse effects; nasal dryness and irritation 13 Other agents not recommended by AHRQ Oral antihistamines Sedating and nonsedating AHRQ outcome not identified Somnolence [aafp.org]

CASE PRESENTATION: Manipulation of carotid sinus may trigger bradycardia or even asystole even in patients without prior history of carotid sinus hypersensitivity. [ncbi.nlm.nih.gov]

pulmonale CT Several features on HRCT chest may appear at any stage of the disease and include 3,4: homogeneous ground-glass opacity: bilateral and symmetric but sometimes [radiopaedia.org]

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