Adams-Stokes Syndrome
| Classification according to ICD-10 | |
|---|---|
| I45.9 | Cardiac conduction disorder, unspecified |
| ICD-10 online (WHO version 2019) | |
As Adams-Stokes syndrome (also: Morgagni-Adams-Stokes attack or shortly MAS attack ) refers to a state brief loss of consciousness ( syncope ), by a paroxysmal occurring brief cardiac arrest (asystole) due to sinus arrest , SA-blocking or AV -Block is caused.
description
The attack is named after the Dublin doctors Robert Adams (1791–1875) and William Stokes (1804–1878); the syndrome was first described by Giovanni Battista Morgagni in 1761.
The conditions are usually characterized by the fact that those affected become unconscious out of complete well-being without any precursors ( prodromi ) and very often injure themselves by falling. Patients may experience seizures due to asystole and subsequent hypoxia. After a short time, when the rhythm "starts" again, the person concerned wakes up again just as suddenly and only has a memory gap for the moment of unconsciousness ( congrade amnesia ). The diagnosis is made in the ECG . But it is sometimes very difficult or even impossible to record such conditions if the patient is not at the moment of the attack, for example. B. carries a long-term EKG storage device. However, after implanting an event recorder or a pacemaker (see below) such events can be read out from the memory later. Pacemakers and other modern implants ( implantable cardioverter defibrillator ) store the derived signals of all heartbeats permanently and can thus confirm the diagnosis afterwards; an event recorder is basically an implanted long-term ECG device.
The causes of the attack are in a arteriosclerotic or inflammatory damage to the conduction system of the heart. A heart attack is also conceivable. The heart muscle is so damaged that the normal electrical impulses that regulate the heart's rhythm cannot be passed from the atria to the ventricles. As a result, the heart pauses until the heart chambers have developed their own replacement rhythm.
The therapy for Adams-Stokes attacks is usually the implantation of a permanent cardiac pacemaker , unless other recoverable causes (e.g. drugs such as digitalis or beta blockers ) are responsible for the symptoms. The patient must be closely monitored between the event and the implantation.
literature
- Giovanni Battista Morgagni : De sedibus et causis morborum. Venice 1761. Tomus IV: Epist. Anatomist. Med. LXIV
- R. Adams: Cases of diseases of the heart accompanied with pathological observations. Dublin Hosp Rep 4, 1827, p. 353.
- W. Stokes: Observations on some Cases of permanently slow pulse. Dublin QJ Med Sci 2, 1846, p. 73.
Web links
- Adams-Stokes syndrome details the history of the discovery of the Stokes-Adams syndrome (Engl.)
