Adam Stokes Seizure
Synonyms in the broadest sense
Morgagni-Adam-Stokes attack (MAS attack)
Definition of the Adam-Stokes attack
The Adam Stokes attack is one of transitory nature Cardiac arrest (asystole) Triggered unconsciousness from which the patient wakes up spontaneously.
history
That was named Adam Stokes Seizure after the two Irishmen Robert Adams and William Stokes.
However, the symptoms were identified as early as the 18th century by the Italian pathologist Giovanni Battista Morgagni described.
causes
An Adam Stokes attack can be triggered by various diseases of the electrical conduction system in the heart.
Since the most synchronous tensioning of the heart muscle cells is necessary for even pumping of the blood, the Heart several pacemaker areas from which an excitation is transmitted to the whole heart via specialized cells.
If this transmission is blocked or the pacemaker is disturbed, the heart cannot or only partially contract and thus cannot pump blood. Functional cardiac arrest occurs. Since no more blood is pumped into the brain, loses the patient that awareness.
There are several causes for the disturbance of the cardiac conduction system:
- In the event of a heart attack, for example, a corresponding failure can occur in an area that is important for the conduction or generation of stimuli.
- Also at Calcification of blood vessels in the heart (arteriosclerosis) there is an increased risk of an Adam Stokes attack.
- In rare cases, inflammation of the heart muscle or an overdose of blood pressure or heart rate lowering agents can also be a trigger.
In the case of the Adam Stokes attack, the patient regains consciousness after a short time, since if a pacemaker system fails, the heart can fall back on subordinate, slower pacemakers that are sufficient for a basic supply of blood to the body.
If this emergency mechanism fails, the patient does not come to himself again and can use the so-called sudden cardiac death die.
Since an affected person does not feel any discomfort or sickness before being unconscious, it comes not infrequently to fall and injuries as a result.
Symptoms
An affected person loses consciousness without notice and wakes up a short time later. The patients usually have no memory of the event (retrograde amnesia) and may have injured themselves in a fall.
diagnosis
The diagnosis of an Adam-Stokes seizure can sometimes difficult if the conduction disorder of the heart is not permanent and can be confirmed by a doctor using an EKG.
Is the person already wearing one? Pacemaker or an implanted defibrillator with built-in memory, disruptions can be made easy read out afterwards.
If irritation disorders are suspected, a Long-term ECG an event may be recorded.
therapy
The only form of therapy currently available is one Implantation of a pacemaker, which takes over the stimulation of the heart muscle cells in the event of a further failure of the internal stimulus generation system.
