When an usually continent person has Enuresis Nocturna, researchers present a persuasive, evidence-based case for broadening the diagnostic workup to include Cardiac Arrhythmias.
The findings were published in the journal Heart Rhythm.
Although involuntary urine during sleep can be an indication of several potentially fatal cardiac arrhythmias, it is rarely evaluated in the diagnostic process. Researchers performed an anonymous internet-based survey in which doctors were asked to choose which diagnostic tests they would order for a patient with inexplicable bedwetting and no other abnormalities.
According to the study results, only 1% of respondents considered an electrocardiogram was necessary.
They always perform urine and kidney ultrasonography, as well as diabetic testing, urinary flow abnormalities, and an encephalogram. Arrhythmic seizures are almost never investigated in the differential diagnosis of unexplained enuresis, according to the findings.
The healthcare industry acknowledges that arrhythmias are a common cause of daytime Syncope(fainting), that it responds well to treatment, and that the ECG is an important tool for assessing it. It’s critical to recognize that the same rhythms that produce syncope in the “awake patient” can also cause nocturnal seizures while sleeping.
If no one witnesses the nocturnal seizures, inexplicable bedwetting may be the only trace of the spectacular incident. Even if, especially in young individuals, the underlying diagnosis for most episodes of enuresis may not be an arrhythmic syncope. However, it is critical to investigate this option, especially if the occurrences are intermittent, as “an ECG is affordable.“
Physicians should constantly inquire about a family history of unexpected death, according to the researcher, as it is an important element of any medical evaluation.