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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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