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Fulltext Coronary artery disease presenting with exercise induced complete heart block. A case report

Koh CS

Med J Malaysia, 1987 Dec;42(4):269-71.

An 84 year old man who presented with Stokes Adams syncope with exertion was found to have complete heart block on walking with reversion to sinus rhythm on recovery. The resting ECG showed evidence of ischemic heart disease with old anteroseptal and old inferior infarction but there was no recent myocardial infarction as shown by normal cardiac enzymes levels. The probable explanation for the mechanism and causation of the transient A-V block is described.

Matched MeSH terms: Syncope/etiology

Dissociative episode secondary to hypoglycemic state in anorexia nervosa: a case report

Ramli M, Hassan AS, Rosnani S

Int J Eat Disord, 2009 Apr;42(3):290-2.

PMID: 19016482 DOI: 10.1002/eat.20596

Hypoglycemic attack had been reported as one of the medical complications in anorexia nervosa.

Matched MeSH terms: Syncope/etiology

Postural blood pressure electrocardiographic changes are associated with falls in older people

Saedon NI, Zainal-Abidin I, Chee KH, Khor HM, Tan KM, Kamaruzzaman SK, et al.

Clin Auton Res, 2016 Feb;26(1):41-8.

PMID: 26695401 DOI: 10.1007/s10286-015-0327-5

To determine the magnitude of postural blood pressure change, differences in ECG between fallers and non-fallers were measured. Postural blood pressure change is associated with symptoms of dizziness, presyncope, and syncope.

Matched MeSH terms: Syncope/etiology

Fulltext Swallow syncope: a case report and review of literature

Siew KSW, Tan MP, Hilmi IN, Loch A

BMC Cardiovasc Disord, 2019 08 07;19(1):191.

PMID: 31391000 DOI: 10.1186/s12872-019-1174-4

BACKGROUND: Swallow or deglutition syncope is an unusual type of neurally-mediated syncope associated with life-threatening bradyarrhythmia and hypotension. It is a difficult condition to diagnose with commonly delayed diagnosis and management. There is lack of review articles that elucidate the basic demographics, clinical characteristics and management of this rare condition. This publication systematically reviews the 101 case reports published since 1793 on swallow syncope.

CASE PRESENTATION: A 59-year-old man presented with the complaint of recurrent dizziness associated with meals. A 24-h ambulatory ECG recording confirmed an episode of p-wave asystole at the time of food intake. Oesophagogastroduodenoscopy with balloon inflation in the mid to lower oesophagus resulted in a 5.6 s sinus pause. The patient's symptoms resolved completely following insertion of a permanent dual chamber pacemaker.

CONCLUSIONS: Swallow syncope is extremely rare, but still needs to be considered during diagnostic workup. It is commonly associated with gastro-intestinal disease. Permanent pacemaker implantation is the first line treatment.

Matched MeSH terms: Syncope/etiology*

Fulltext Torsade de pointes and syncopal attacks in a 26-year old woman with congenital complete heart block and prolonged QT interval

Quek DK, Ong SB

Singapore Med J, 1990 Apr;31(2):185-8.

PMID: 2371586

A 26-year old woman with congenital complete heart block and prolonged QT interval presented for the first time with syncopal attacks associated with torsade de pointes in adulthood. Cardioversion followed by overdrive pacing was needed to finally control the unstable rhythm. During episodes of non-capture, paraoxysms of torsade de pointes leading to ventricular flutter were recorded by a 24-hour ambulatory electrocardiographic monitoring. Beta-blockade and permanent ventricular pacing finally abolished both the syncopal attacks and the torsade phenomena. The prognosis of congenital complete heart block associated with QT prolongation resembles that of the Romano-Ward syndrome. Recognition of this variant would facilitate earlier treatment of this rare but potentially lethal disorder.

Matched MeSH terms: Syncope/etiology*

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