A Rare Case of Asystole Due to Exaggerated Vagal Tone Following Chest Tube Placement.

Publication/Presentation Date

12-1-2025

Abstract

Excessive vagal tone can lead to unstable bradyarrhythmias. We present the case of a 39-year-old otherwise healthy man who failed outpatient treatment for community-acquired pneumonia with oral antibiotics and underwent left-sided chest tube placement for empyema. After chest tube placement, the patient had a first-ever episode of syncope, which on telemetry coincided with a 16-second pause and asystole followed by the spontaneous recovery of sinus rhythm. Electrolytes and high-sensitivity troponin were within normal limits. The electrocardiogram (EKG) did not reveal any signs of ischemia. Eventually, the chest tube was removed after the drainage of pleural fluid, and the patient did not have any recurrence of arrhythmia or symptoms. He was discharged home after the completion of intravenous antibiotics.

Volume

17

Issue

12

First Page

98599

Last Page

98599

ISSN

2168-8184

Disciplines

Medicine and Health Sciences

PubMedID

41510470

Department(s)

Fellows and Residents

Document Type

Article

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