Clinical features
Symptoms:
- recurrent syncopal attacks (Stokes-Adams) or dimming of consciousness due to bradycardia (80%) or VT/VF (20%)
- pallor may be accompanied by disorientation or convulsions
- dyspnoea - the need for an increased stroke volume may produce biventricular failure
On examination:
- regular bradycardia (30-50 bpm)
- wide pulse pressure
- variable cannon waves in neck
- variable intensity of first heart sound
- variable ventricular filling sounds
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