In this article, we will discuss the Clinical Features of Stokes-Adams Syndome. So, let’s get started.
The typical attacks of Stokes-Adams syndrome are characterized by frequent faintings without any warning symptoms; and in majority of the cases, high grade or complete AV block is detected. In patients with these attacks, the block may be persistent or temporary with a subsidiary pacemaker below the block which either fails to function or functions at slow rate producing bradycardia. If the attacks occur during standing, the patient may fall and hurt himself/herself. Should the attack persists more than 8 to 10 seconds, the patient turns pale, falls unconscious and may exhibit few clonic jerks. If an attack persist with longer period (2-3 minutes) asystole results leading to irregular breathing, cyanosis, fixed pupils, incontinence of urine and bilateral plantar extensor response. The giant waves in Leeds V2-V4 is virtually diagnostic of recent syncopal attack. The recovery from such attacks is also prompt and complete without permanent impairment of mental functions. After recovery patient does not recall presyncopal symptoms.
Pathognomic sign of Stokes-Adams attack on ECG
Large, broad, bizzare and inverted T-waves called giant ‘T’ in leads V2-V4 is visually pathognomic sign of recent syncopal attack; if present. This is associated with prolonged QTc interval.