Atishoo! Atishoo! we all fall down!
We report the unusual case of an elderly lady with glaucoma and sneeze syncope because of transient complete atrioventricular block, who had resolution of syncopal and pre-syncopal symptoms following removal of her beta-blocker eyedrops. This case suggests a previously unrecognised pathophysiology in sneeze syncope and illustrates the potential problems associated with the systemic absorption of beta-blocker eyedrops as well as the ingenuity of older patients when participating in the investigation of their own illnesses.
Carey
Brian J
BJ
Department of Geriatric Medicine, Bantry General Hospital, Bantry, Co. Cork, Ireland. brian.carey@mailp.hse.ie
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000369:Aged, 80 and over; D015716:Electrocardiography, Ambulatory; D005260:Female; D005901:Glaucoma / Q000188:drug therapy; D006327:Heart Block / Q000139:chemically induced / Q000150:complications / Q000209:etiology*; D006801:Humans; D009883:Ophthalmic Solutions; D012912:Sneezing; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology; D013999:Timolol / Q000008:administration & dosage / Q000009:adverse effects*
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D013999:Timolol