Evidence map›Paper›PMID 41216055›Full record

ArticleCureus2025

The Cardio-Biliary Reflex in Gallbladder Disease: A Case Report and Literature Review.

Rafat Shehata, Amr Anos, Mohammed Fathy Kandil Mohammed, Mostafa Hekal, Mohamed Elatiky

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rafat ShehataEmergency Medicine, Hampshire Hospitals NHS Foundation Trust, Basingstoke, GBR.
Amr AnosCardiology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, GBR.
Mohammed Fathy Kandil MohammedEmergency Medicine, Hampshire Hospitals NHS Foundation Trust, Basingstoke, GBR.
Mostafa HekalGeneral Practice, Bolton NHS Foundation Trust, Bolton, GBR.
Mohamed ElatikyGeneral Practice, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This case report describes an elderly female presenting with simultaneous biliary colic and symptomatic sinus bradycardia. The resolution of her bradycardia with pain management alone suggested Cope's sign, or the cardio-biliary reflex (CBR), as the underlying cause. This reflex is a well-recognized physiological response in which gallbladder pathology triggers vagal nerve signals, potentially causing significant alterations in cardiac rhythm and often mimicking primary heart conditions. This case illustrates that even uncomplicated biliary colic can induce this effect and emphasizes the importance for clinicians to consider this reflex in the differential diagnosis of bradyarrhythmia accompanied by abdominal pain. Recognizing CBR is crucial for directing management toward the correct biliary pathology and avoiding unnecessary cardiac investigations or interventions.

Indexed as

bradyarrhythmiacardio-biliary reflexcholelithiasiscope’s signelectrocardiogram (ecg)

Identifiers

PMID41216055
PMCPMC12596752

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.