Recurrent syncopal episodes of neurocardiogenic origin in a patient suffering from cardiac syndrome-X.
We describe the case of a 44-year-old man, with a history of recurrent syncopal episodes and effort angina, the latter attributed to cardiac syndrome-X, who was admitted to our department because of a syncopal episode. During his hospitalization laboratory investigations including haematologic and blood chemical findings, head C/T scan, electroencephalogram, 48-hour Holter monitoring, electrophysiologic testing and echocardiographic study disclosed no abnormalities. On the contrary, a passive upright tilt testing was found to be positive, resulting, approximately, in a 10-seconds time interval of asystole accompanied by syncope. The association in the same patient of cardiac syndrome-X and neurocardiogenic syncope, although never described before, might be explained by a similar pathophysiological mechanism, which is a sympathovagal imbalance.
Rentoukas
E I
EI
Department of Cardiology, Athens General Hospital G. Gennimatas, Greece.
Lazaros
G A
GA
Deftereos
S G
SG
Zacharoulis
A A
AA
D000328:Adult; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D015716:Electrocardiography, Ambulatory; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000175:diagnosis* / Q000209:etiology; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000209:etiology; D018667:Tilt-Table Test