Bryan Curtis, Thomas Hughes, Dalila Lo Bue, Christopher J Salgado
Introduction: The vasovagal response is a normal physiologic response that consists of sequential changes in blood pressure, heart rate, and contractility that resolves spontaneously in normal patients. This normal response can be problematic in patients with a compromised cardiovascular system who require surgery.
Case Summary: We report two cases of defecation syncope with cardiac arrest. Both patients had preexisting cardiovascular disease and no premonitory syncope symptoms. Both patients were returned to spontaneous circulation following initiation of ACLS protocol, but died later in the hospital course secondary to complications of cardiac arrest.
Conclusion: Promoting hydration, incorporating a stool softener into the medication regimen, and squatting during bowel movement may aid in reducing the risk for syncope and associated cardiac arrest with defecation.