Abstract
A report has been presented of a patient who had an obstructive jaundice because of a common bile duct stone and an unusual electrocardiographic tracing. The literature on cardiac physiology in the presence of biliary pathology is briefly discussed. It is believed that the unusual electrocardiographic tracing in this patient was because of a reflex vagal suppression of the S-A node, allowing an idioventricular pacemaker to dominate rate and conduction of the myocardial contractions. Blocking of this vagal reflex by atropine was an important factor in the operative and postoperative management of this patient.
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