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Bell K, Elmograbi A, Smith A, et al. Paradoxical bradycardia and hemorrhagic shock. Proc (Bayl Univ Med Cent). 2019;32(2):240-241doi: 10.1080/08998280.2018.1559386.
Bell, K., Elmograbi, A., Smith, A., & Kaur, J. (2019). Paradoxical bradycardia and hemorrhagic shock. Proceedings (Baylor University. Medical Center), 32(2), 240-241. https://doi.org/10.1080/08998280.2018.1559386
Bell, Kendall, et al. "Paradoxical bradycardia and hemorrhagic shock." Proceedings (Baylor University. Medical Center) vol. 32,2 (2019): 240-241. doi: https://doi.org/10.1080/08998280.2018.1559386
Bell K, Elmograbi A, Smith A, Kaur J. Paradoxical bradycardia and hemorrhagic shock. Proc (Bayl Univ Med Cent). 2019 Mar 14;32(2):240-241. doi: 10.1080/08998280.2018.1559386. eCollection 2019 Apr. PMID: 31191139; PMCID: PMC6541057.
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Proc (Bayl Univ Med Cent). 2019 Mar 14;32(2):240-241. doi: 10.1080/08998280.2018.1559386. eCollection 2019 Apr.

Paradoxical bradycardia and hemorrhagic shock.

Proceedings (Baylor University. Medical Center)

Kendall Bell, Adel Elmograbi, Antonio Smith, Jasleen Kaur

Affiliations

  1. Department of Internal Medicine, Wayne State University/Detroit Medical CenterDetroitMichigan.

PMID: 31191139 PMCID: PMC6541057 DOI: 10.1080/08998280.2018.1559386

Abstract

Hypotension, poor peripheral perfusion, and tachycardia are the most common presenting signs of hemorrhagic shock. Many patients fail to show initial signs of tachycardia and paradoxically present with bradycardia. An 81-year-old man presenting with lower gastrointestinal bleed showed initial vital signs significant for tachycardia and normal blood pressure. After resuscitation with fluids and blood products, his heart rate stabilized to between 64 and 86 bpm. It later dropped to 30 bpm, which improved after administration of atropine. The patient soon experienced two episodes of hematochezia. The paradoxical bradycardia proved to be a false reassurance that the hemorrhage had resolved. Identification of paradoxical bradycardia is important in suspecting ongoing gastrointestinal hemorrhage.

Keywords: Bradycardia; hemorrhagic shock; paradoxical bradycardia; relative bradycardia

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