Bezold Jarisch Reflex- New Interest, Old Phenomenon
American Journal of Internal Medicine
Volume 8, Issue 1, January 2020, Pages: 24-29
Received: Dec. 13, 2019; Accepted: Jan. 6, 2020; Published: Jan. 16, 2020
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Sanjeev Arya, Medical Intensive Care Unit, Max Super Specialty Hospital, Dehradun, India
Shantanu Belwal, Medical Intensive Care Unit, Max Super Specialty Hospital, Dehradun, India
Bhupesh Uniyal, Medical Intensive Care Unit, Max Super Specialty Hospital, Dehradun, India
Bhuwan Tiwari, Department of Cardiology, Ram Manohar Lohia Institute of Medical Sciences, Gomti Nagar, Lucknow, India
Preeti Sharma, Department of Cardiology, Max Super Specialty Hospital, Dehradun, India
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Bezold Jarisch reflex (BJR) is an eponym for a triad of responses namely: bradycardia, hypotension and vasodilation that develops upon stimulation of intracardiac mechanoreceptors and is mediated by vagal afferent nerve fibers. Though it was first reported in 1867 it remains a topic of discussion due to its implications in various clinical scenarios. The reflex can be stimulated either by mechanical or chemical stimulators. Often considered a physiologic response, if identified by the clinician at earlier phase, can avoid cardiac complication, it also acts as a prognostic indicator in various diseases. This review focuses on the physiology of the BJR and its possible physiologic role in several clinical situations. We used evidence obtained from a computerized literature of medical databases search using PubMed/Medline/NIH (all articles till October 2019). The search was carried out with MeSH phrase “Bezold Jarisch reflex” and articles were limited to English language only. The relevant published reports, abstracts and human studies with clinical cases to determine the clinical implications of BJR were considered for the review. It has been concluded that BJR is a physiologic response that can occur in number of clinical scenarios. Therefore, simultaneous occurrence of bradycardia and hypotension should alert clinicians to the possibility of BJR.
Bezold Jarisch Reflex, C-fibers, Chemoreceptors, Myocardial Receptors
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Sanjeev Arya, Shantanu Belwal, Bhupesh Uniyal, Bhuwan Tiwari, Preeti Sharma, Bezold Jarisch Reflex- New Interest, Old Phenomenon, American Journal of Internal Medicine. Vol. 8, No. 1, 2020, pp. 24-29. doi: 10.11648/j.ajim.20200801.15
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This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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