There are a few hypotheses to explain the relationship between ECG abnormalities or myocardial injury and acute pancreatitis, which includes: [1]
vagally mediated reflexes (cardiobiliary reflex) (2,3); [2] electrolyte abnormalities, such as hypokalemia, hypocalcaemia, hyponatraemia (2); [3] toxic effects of pancreatic proteolytic enzymes on myocardium--trypsin can change platelet adhesiveness, influence the coagulation system and lead to coronary thrombosis (5); [4] coronary artery spasm (3); [5] haemodynamic instability and /or systemic inflammatory response (SIRS) induces cardiac damage such as severe sepsis or septic shock (3); and [6] prothrombotic derangement (3).
The probable cause of syncope is vasovagal syncope (VVS) occurring because of profound systemic hypotension due to reex vasodilatation, or
vagally driven bradycardia, or both followed by dizziness, presyncope and finally syncope.
Influence of NG-nitro-L-arginine methyl ester on
vagally induced gastric relaxation in the anaesthetized rat.
Trait Self-Compassion Reflects Emotional Flexibility Through an Association with High
Vagally Mediated Heart Rate Variability.
Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure.
Vagally triggered sinus bradycardia secondary to increased ICP has been reported as early as 1901 by a well-known phenomenon known as "Cushing's reflex." It is a response by the autonomic nervous system to ensure adequate cerebral perfusion despite increased ICP [6].
The BJ reflex is a
vagally medicated response secondary to direct chemical stimulation of cardiac receptors.
The cardiac autonomic functions are based on the assumption that blood pressure responses are mediated through sympathetic nervous system and heart rate response is
vagally mediated.
Vagally mediated component of HRV reflects adaptivity (maladaptivity) to environmental challenges and indexes ability (inability) to modulate affect responses." [20] In addition to establishing an association between depression and altered HRV parameters, the study has also demonstrated a direct relationship of severity of depression with the extent of autonomic imbalance suggesting possibility of HRV as a prognostic tool in the management of these patients.
Time and frequency domain parameters for HRV analyses Variable Unit Description Time Domain Parameters Mean RR ms Average RR interval SDNN ms Standard deviation of all NN interval RMSSD ms The square root of the mean squared difference between adjacent N-N intervals, reflects mainly
vagally influence pNN50 % Percentage of normal normal intervals greater than 50 milliseconds Frequency Domain Parameters VLF [ms.sup.2] Power spectrum band between 0.003-0.04 Hz LF [ms.sup.2] Power spectrum band between 0.04-0.15 Hz, reflects sympathetic activity HF [ms.sup.2] Power spectrum band between 0.15-0.4 Hz, reflects parasympathetic activity LF/HF n.u.