We report a case of gastric dilatation in a ventilated 18 year-old wom
an, which was revealed by the acute onset of hypotension, sinus bradyc
ardia, and complete atrioventricular block. Hypotension and cardiac rh
ythm disturbances resolved with intravenous injection of atropine, but
recurred a few minutes later and required a second bolus of atropine,
which had a transient beneficial effect. Only gastric decompression,
as soon as gastric distention was recognized, was able to restore norm
al cardiac rhythm and adequate blood pressure. This case highlights th
e seriousness of gastric dilatation and argues for the vagal mechanism
of cardiac rhythm and conduction troubles complicating gastric dilata
tion.