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Unbound Medicine.
(Cardiogenic syncope)
22,476 results
  • Clinically Significant Bradycardia and Hypotension Following Consumption of Betel Leaf in a Patient Treated for Chronic Atrial Fibrillation. [Journal Article]
    J Pharm Pract. 2021 Sep 27 [Online ahead of print]Bannister BE, Parry DR, Pouliot JD
  • CONCLUSIONS: A 66-year-old Nigerian woman presented to the emergency department for evaluation of multiple near syncope episodes with underlying AF and slow ventricular response. After initial evaluation, the patient disclosed she had ingested several betel leaves that morning. She was admitted for observation of severe, progressive hypotension and symptomatic bradycardia. Her past medical history included AF, type 2 diabetes, asthma, obesity, hypertension and hypothyroidism. Her home medications consisted of spironolactone, metoprolol succinate, and verapamil ER. Upon admission, her home medications were held. She received IV fluids and atropine .4 mg IV as needed for symptomatic bradycardia. Approximately 18 h following admission, her vital signs stabilized and her labs returned to baseline. She remained stable and was discharged with a recommendation to continue her home medications at prescribed doses with reduced doses of verapamil and metoprolol and to follow-up with her primary care provider.A patient with a history of AF developed significant hypotension and symptomatic bradycardia after betel leaf consumption resulting in an overnight critical care unit admission. The use of betel leaf is not common in the United States; however, practitioners should be cognizant of the use of complementary and alternative medications like betel leaf and incorporate this knowledge in patient evaluation. Patients consuming betel leaf or betel nut should be evaluated for cardiovascular effects as well as laboratory evaluation for organ damage.
  • Aortic Dissection as the Culprit for Seizure. [Case Reports]
    Cureus. 2021 Aug; 13(8):e17325.Rivera-Alvarez F, Qureshi M, … Ganti L
  • The authors present a case of syncope that was caused by aortic dissection. As the main artery to the system circulation, aortic dissection can manifest in numerous ways. This case reminds the clinician of the high index of suspicion necessary to diagnose this potentially life-threatening problem. Indeed, the mortality rate increases 2% per hour in the first 24 hours for a type A aortic dissectio…
  • Catecholaminergic Crisis After a Bleeding Complication of COVID-19 Infection: A Case Report. [Case Reports]
    Front Endocrinol (Lausanne). 2021; 12:693004.Rebollo-Román A, Alhambra-Expósito MR, … Herrera-Martínez AD
  • The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents in some cases with hemostatic and thrombotic complications. Pheochromocytomas are unusual, though potentially lethal tumors. Herein we describe the first case of hemorrhage in a pheochromocytoma related to SARS-CoV-2 infection. A 62-year-old man consulted for syncope, fever, and palpitations. He was diagnosed with SARS-CoV-…
  • Exercise Stress Test-Induced Atrioventricular Dissociation With Syncope. [Case Reports]
    Ochsner J. 2021 Fall; 21(3):319-324.Oo ZT, Bhavsar D, … Kyaw H
  • Background: The exercise stress test is widely used as a diagnostic test for evaluating coronary artery disease in symptomatic patients or those with underlying cardiovascular disorders. Although exercise stress test risk is minimal with a <1% chance of causing heart block, physician awareness of potential complications is paramount for prompt recognition and treatment. Case Report: A 65-year-old…
  • Sudden cardiac death in patients with myocardial infarction: 1.5 primary prevention. [Review]
    Rev Cardiovasc Med. 2021 Sep 24; 22(3):807-816.Feng YT, Feng XF
  • Sudden cardiac death (SCD) is one of the most common causes of death in the world. Coronary heart disease (CHD) is the root cause of most patients with SCD, and myocardial infarction (MI) is the main cause of SCD among all types of CHD. Early identification of high-risk patients after an MI, and the application of related prevention strategies and disease-specific treatments will be the key to re…
  • [Tachycardia and syncope in a 15-year-old teenager]. [Journal Article]
    Herzschrittmacherther Elektrophysiol. 2021 Sep 22 [Online ahead of print]Klingenheben T
  • Patients with highly symptomatic tachycardia may suffer significantly; in addition to a standardized rule-out of structural heart disease, secondary causes need to be excluded. Disorders such as inappropriate sinus tachycardia and postural tachycardia syndrome are caused by cardiac autonomic dysregulation which may be part of a rare underlying noncardiac disease.
  • Heart rate variability and heart rate turbulence in patients with vasovagal syncope. [Journal Article]
    Kardiologiia. 2021 Aug 31; 61(8):54-59.Akıncı S, Çoner A, … Müderrisoğlu İH
  • Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope.Material and methods Patie…
  • Kearns-Sayre Syndrome With Persistent Ventricular Tachycardia Refractory to Shocks and Medications. [Case Reports]
    Cureus. 2021 Aug; 13(8):e17175.Udongwo N, Gor D, … Daniels S
  • Cardiovascular conduction delay makes up part of the triad associated with Kearns-Sayre syndrome (KSS). Although there have been a few reported cases of prolonged Qtc and polymorphic ventricular tachycardia associated with this disease, despite the use of automatic implantable cardioverter defibrillators (AICD) for secondary prevention, some cases have been reported where the use of AICD did not …
  • Syncope-presyncope and dizziness, differential diagnosis. [Journal Article]
    Minerva Med. 2021 Sep 20 [Online ahead of print]Pecci R, Ceccofiglio A
  • To date, there are no doubts about the evaluation of patients with syncope, while differential diagnoses between presyncope and nonspecific symptoms, generically referred to as dizziness, are complex and not clearly standardized. This paper aims to highlight the most frequent vestibular diseases, which can mimic a pre-syncopal episode in adult and older patients. It should be noted that nonspecif…
  • Neurologic and musculoskeletal effects of tilt-table standing on adults: a systematic review. [Review]
    J Phys Ther Sci. 2021 Sep; 33(9):700-706.Bohannon RW, Green MD
  • [Purpose] Tilt table use is associated, most often, with the assessment of syncope. However, it also has applications for patients with neurologic and orthopedic problems. These applications do not appear to be widely applied. The purpose of this review, therefore, was to summarize the research literature addressing the use of tilt tables for treating specific musculoskeletal and neurologic impai…
  • Ventricular Arrhythmias in Athletes: Role of a Comprehensive Diagnostic Workup. [Journal Article]
    Heart Rhythm. 2021 Sep 15 [Online ahead of print]Dello Russo A, Compagnucci P, … Tondo C
  • CONCLUSIONS: A comprehensive invasive workup provided additional diagnostic elements and could improve the sports eligibility assessment of athletes presenting with VAs. The presented extensive invasive evaluation could be especially helpful when noninvasive tests show unclear findings.
  • Can I Send This Syncope Patient Home From the Emergency Department? [Journal Article]
    J Emerg Med. 2021 Sep 14 [Online ahead of print]Tannenbaum L, Keim SM, … Mattu A
  • CONCLUSIONS: Syncope remains a difficult chief symptom to disposition from the ED. The CSRS is modestly effective at establishing a low probability of actionable disease or need for intervention. However, CSRS might not reduce unnecessary hospitalizations. The FAINT score has yet to undergo validation; however, the initial derivation study offers less diagnostic accuracy compared with the CSRS.
  • Ruptured sinus of valsalva aneurysm presenting as syncope and hypotension: a case report. [Journal Article]
    BMC Cardiovasc Disord. 2021 Sep 17; 21(1):449.Zhuo GY, Zhang PY, … Xiang T
  • CONCLUSIONS: It is very important to be vigilant about the existence of SOVA. RSOVA should be suspected in a patient presenting with acute hemodynamic compromise, and echocardiography should be immediately performed. Moreover, it is very important to achieve dynamic monitoring by using cardiac color ultrasound. Definitive diagnosis often requires cardiac catheterization, and an aortogram should be performed unless endocarditis is suspected.
  • Living with hypertrophic cardiomyopathy: the patient's perspective. [Journal Article]
    Future Cardiol. 2021 Sep 17 [Online ahead of print]Borsari W, Davis L, … Barbara McDonough
  • Hypertrophic cardiomyopathy (HCM) is a complex disease characterized by thickening of the cardiac muscle. Common symptoms include chest pain, shortness of breath, palpitations, fatigue and syncope (fainting), which are often confused for other conditions. Clinical treatment focuses on the relief of symptoms with medical therapies, which provide adequate to more variable symptomatic relief. Patien…
  • Triage assessment of transitory loss of consciousness in the emergency department-A retrospective observational study. [Journal Article]
    J Adv Nurs. 2021 Sep 17 [Online ahead of print]Zaboli A, Ausserhofer D, … Turcato G
  • CONCLUSIONS: Despite the good specificity, the low sensitivity does not currently allow the Manchester Triage System to completely exclude patients with a severe acute disease who presented in the emergency department for a transitory loss of consciousness. Therefore, it is important to develop precise nursing tools or assessments that can improve triage performance.The assessment of a complex symptom can create difficulties in the stratification of patients in triage, assigning low-priority codes to patients with a severe disease. Additional tools are needed to allow the correct triage assessment of patients presenting with transitory loss of consciousness.
  • COVID-19-Associated Dysautonomia. [Case Reports]
    Cureus. 2021 Aug; 13(8):e17156.Suresh K, Alam MDU, Satkovich E
  • Orthostatic hypotension (OH) refers to a significant reduction in blood pressure (BP) that occurs on standing. It mainly results when autonomic reflexes are impaired or when the intravascular volume is depleted. Symptoms can range from syncope, dizziness, even angina or stroke. Major mechanisms causing OH are autonomic dysfunction affecting the baroreflex, severe volume depletion, and adverse med…
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