A case report of Adams-Stokes syndrome: Complete atrio-ventricular block manifested as cardiogenic syncope

Introduction/objective: Syncope is a sudden and transient loss of consciousness caused by brain tissue hypoperfusion. The Adams-Stokes Syndrome (ASS) is a type of arrhythmia that manifests as cardiogenic syncope. It is very quick and simple to make the diagnosis by analysing an ECG tracing, which most commonly shows a complete atrioventricular block (AV block), or a second-degree AV block with a slow ventricular response. The objective of this paper is to present the case of a patient who suffered from syncope after physical therapy, as a result of the Adams-Stokes Syndrome caused by a complete AV block. Case report: The patient is a 74-year-old woman, stating that she felt faint and weak after getting off the bus, after which she lost consciousness and fell, suffering a head injury as a result. Upon examination, she was conscious, oriented, but hypotensive with a blood pressure of 75/50 mmHg, and bradycardic with a heart rate of 32 bpm. Her ECG tracing showed a complete AV block with a ventricular response of 24/min, without signs of myocardial ischemia. Conclusion: Since an unrecognised Adams-Stokes Syndrome can lead to serious health complications and even sudden cardiac death, a standardisation of performing prehospital ECG diagnostics is necessary for every patient who clinically presents with syncope or convulsions.