Bezold Jarisch Reflex- New Interest, Old Phenomenon

Abstract

Abstract: 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. Keywords: Bezold Jarisch Reflex, C-fibers, Chemoreceptors, Myocardial Receptors