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Heart Rate Deficit from Dysautonomia in a Bariatric Surgery Patient - An Unusual Cause of Recurrent Syncope

Since development of laparoscopic sleeve gastrectomy in 1999, bariatric surgery (BS) for morbid obesity has become increasingly common due its minimally invasive nature in conjunction with demonstrated mortality benefit.(1)The greatest weight loss occurs 6-24 months postoperatively.(2,3)Patients undergoing bariatric surgery are prone to develop symptomatic autonomic dysfunction with associated orthostatic intolerance potentially causing syncope. (4,5)(6)We report a case of bradycardia-mediated syncope without associated hypotension in a patient who had prior BS.

Credits: Rakesh Gopinathannair, MD, MA, Iftekhar Ahmed, MD, Krishna Akella, DO, Luis Couchonnal, MD, Ghulam Murtaza, MD, DhanunjayaLakkireddy, MD, Brian Olshansky, MD