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Paradoxical respiratory sinus arrhythmia due to a large thoracic empyema in an ambulatory patient

Authors
Journal
Autonomic Neuroscience
1566-0702
Publisher
Elsevier
Identifiers
DOI: 10.1016/j.autneu.2014.06.006
Keywords
  • Paradoxical Respiratory Sinus Arrhythmia
  • Retro-Cardiac Mass
  • Empyema
  • Bi-Ventricular Outflow Tract Obstruction
  • Cardio-Respiratory Autonomic Interplay
Disciplines
  • Biology
  • Medicine

Abstract

Abstract We report a case of paradoxical respiratory sinus arrhythmia (PRSA) caused by a retro-cardiac empyema in an ambulatory patient. The case describes the dynamics and deleterious impact of PRSA on cardio-respiratory cycle, its electrocardiographic, radiologic and echocardiographic findings. Furthermore, it discusses a probable mechanism of paradoxical respiratory sinus arrhythmia in the setting of a retrocardiac mass and suggests a need for physicians to check for the changes in ventilation perfusion mismatch and rise in physiological dead space in such patients. In conclusion, to the best of our knowledge, this is the first documented report of paradoxical respiratory sinus arrhythmia in an ambulatory, non-anesthetized spontaneously breathing patient.

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