Gupta, Aditya ArunAgarwal, ShikhaAnand, Udita2024-09-242024-09-242023-06Gupta Aditya Arun, Agarwal Shikha, Anand Udita. Defecation Syncope: A Rare Manifestation in Covid Patients . International Journal of Contemporary Medical Research. 2023 Jun; 10(6): 1-22393-915X2454-7379https://imsear.searo.who.int/handle/123456789/228165Introduction: Physical activity leads to raised oxygen demand. This causes desaturation in patients with moderate to severe ARDS. Case Report: A 65yr/M was admitted complaining of breathlessness, cough and fever. RT-PCR was positive, inflammatory markers raised and HRCT Thorax consistent with covid findings. The patient was a known hypertensive taking Tab. Telmisartan (40mg). He had received 1st dose of Covishield vaccine. Treatment was initiated according to covid protocol. Oxygen therapy via NRBM mask at 10-15 litres was started and saturation maintained at 90-95%. On 9th day of admission, pt’s. saturation fell to 77%, while defecating. Subsequently, similar episodes were noted. Saturation fell to 55% transiently prompting BiPAP intervention. On Day 12 a severe episode of desaturation was noted but patient improved, without needing intubation. Diagnosis of Defecation Syncope was made. Discussion: Defecation Syncope (DS) is a parasympathetic response to the exerted pressure on the rectum and diaphragm, and closure of the epiglottis during defecation. Initially there is rise in BP and bradycardia, then rapid fall in BP leading to decreased cerebral perfusion causing syncope. Secondly, raised intra-abdominal pressure causes the diaphragm to exert greater pressure on the thoracic cavity. A (V/Q) mismatch causes hypoxia and desaturation in such patients. Constipation predisposes to DS. Conclusion: While these patients perform voiding activity, adequate fluid therapy should be initiated. Oxygen flow should be increased. Laxatives should be used judiciously. Emergency trolley should be kept on standby. Occasionally, such patients may have fatal outcomes. Patients should be under vigilance of healthcare providers.Defecation SyncopeManifestationCovid PatientsJournal ArticleIndiaDepartment of Anaesthesiolgy, SMSR, Sharda Hospital, Greater Noida, Uttar Pradesh- 201306Department of Anaesthesiolgy, SMSR, Sharda Hospital, Greater Noida, Uttar Pradesh- 201306Department of Anaesthesiolgy, SMSR, Sharda Hospital, Greater Noida, Uttar Pradesh- 201306