Asystole Clinical Presentation

Updated: Mar 31, 2020
  • Author: Sandy N Shah, DO, MBA, FACC, FACP, FACOI; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Presentation

History and Physical Examination

History

Immediate diagnosis of asystole requires the recognition of a full cardiac arrest and a confirmed flat-line rhythm in 2 perpendicular leads. Lightheadedness or syncope may precede asystole when it follows a bradyasystolic rhythm.

Physical examination

If the rhythm is truly asystole and has been present for more than several seconds, the patient will be unconscious and unresponsive. A few agonal (final gasping) breaths may be noted, but detectable heart sounds and palpable peripheral pulses are absent.