?Healthy?, 60ish year old male out patient surgery patient had a history of "vasovagal" episodes. Went from HR 70's, SBP 120's, to HR 38 - 40, SBP 60's. Patient said he was okay, just tired, he responded appropriately to me the whole time.
I notified anesthesia, he said, "Yeah, he has these vasovagal episodes, it just means the cardiologists don't know exactly why or what causes it, just watch him."
Long story short, I did no interventions except ran his IV wide open and kept him in slight trendelenberg. His vital signs stayed low for over an hour.
His wife is an RN, she came in and said, "Yeah he does this, it usually doesn't last this long, yeah he has been "worked up," he normally drinks a lot of water, he just needs more fluids."
Vitals returned to normal, he said he just felt tired, and went home. He said something about "they think my blood pools in my legs and forgets to pump back to my heart" as he was getting dressed. (I guess I could have, should have, put on SCD'S?) Called him the next day, he was fine.
Took about a week for my heart rate to return to normal!!!!
Have you seen anything like this?
Wouldn't some kind of pacemaker be indicated?