Symptomatic Sinus Bradycardia in a Patient With Acute Calculous Cholecystitis Due to the Cardio-Biliary Reflex (Cope's Sign): A Case Report

Cureus. 2022 Jun 1;14(6):e25585. doi: 10.7759/cureus.25585. eCollection 2022 Jun.

Abstract

Acute cholecystitis may present cardiovascular manifestation like cardiac ischemia leading to detailed cardiac workup without any obvious cardiac pathology. Here we describe a case who presented with typical signs and symptoms of cholecystitis exhibiting sinus bradycardia. This reflexive bradycardia was a result of autonomic vagal innervation and was resolved after cholecystectomy. This case highlights the importance of the cardio-biliary reflex and recommends clinicians ensure expedited management of cholecystitis to avoid unnecessary extensive cardiac workup.

Keywords: acute calculus cholecystitis; bradyarrythmia; cardiac autonomic activity; cardio-biliary reflex; copes sign.

Publication types

  • Case Reports