Search Our Scientific Publications & Authors

Publications
find publications by category +
Translate page:

Dizziness in an avid cyclist: an unusual presentation of a common problem.

Authors:
Aish Sinha Ozan M Demir Howard Ellis Divaka Perera

Eur Heart J Case Rep 2021 Dec 6;5(12):ytab459. Epub 2021 Dec 6.

British Heart Foundation Centre of Excellence and National Institute for Health Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, Westminster Bridge Rd, London SE1 7EH, UK.

Background: Presyncope and syncope are common presentations with a wide range of differential diagnoses; when it occurs primarily on exertion, a cardiovascular cause is more likely. Structural abnormalities and primary rhythm disturbances are the usual culprits in these patients.

Case Summary: A 75-year-old gentleman presented with a history of progressive exertional presyncope. His investigations demonstrated normal cardiac structure, function, and rhythm. He underwent an exercise stress test, which demonstrated a significant reduction in peak blood pressure with equivocal electrocardiogram changes and absence of ischaemic symptoms. In view of his age and gender, a computerized tomography coronary angiogram (CTCA) was organized to exclude obstructive coronary artery disease (CAD). Intriguingly, the CTCA demonstrated a severe proximal left anterior descending (LAD) artery stenosis. This stenosis was confirmed to be functionally significant using invasive coronary physiology and was treated with percutaneous coronary intervention. At follow-up, there was no recurrence of exertional presyncope and the patient was continuing to return to his baseline function.

Conclusion: Presyncope and/or syncope as the sole manifestation of obstructive CAD, in the presence of normal ventricular function and valves, has rarely been reported. Myocardial ischaemia-mediated presyncope and/or syncope may be secondary to numerous mechanisms, which are described in this case report. Revascularization of the functionally significant proximal LAD stenosis resulted in cessation of exertional presyncope in our patient. The long-term outcome of revascularization in patients with presyncope and syncope needs to be further investigated.

Download full-text PDF

 Source
http://dx.doi.org/10.1093/ehjcr/ytab459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728714PMC
December 2021

Publication Analysis

Top Keywords

exertional presyncope
12
and/or syncope
8
presyncope patient
8
presyncope syncope
8
presyncope and/or
8
presyncope
7
ctca demonstrated
4
demonstrated severe
4
severe proximal
4
proximal left
4
left anterior
4
anterior descending
4
syncope investigated
4
descending lad
4
cad intriguingly
4
lad artery
4
artery stenosis
4
stenosis stenosis
4
stenosis confirmed
4
confirmed functionally
4

Keyword Occurance

Similar Publications

Exertional Dyspnea as the Main Symptom in an Adolescent Athlete With Coronary Artery Anomaly - A Case Report.

Authors:
Mahdi Sareban Klaus Hergan Peter Covi Josef Niebauer

Front Cardiovasc Med 2022 11;9:872608. Epub 2022 Apr 11.

University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.

Coronary artery anomalies (CAA) are associated with sudden cardiac death (SCD) and the majority of those events occur during exercise. Depending on the anatomic features and severity, CAA usually provoke clinical symptoms of coronary ischemia, mainly syncope and (exertional) chest pain. Here we present a case of a female adolescent athlete with a high-risk CAA variant and an unusual clinical presentation, which delayed diagnosis 2 years after first symptoms were reported. Read More

View Article and Full-Text PDF
April 2022
Similar Publications

Case report: DSP truncation variant p. R1951X leads to arrhythmogenic left ventricular cardiomyopathy.

Authors:
Vincent Chen Bradley P Knight Elizabeth M McNally

Eur Heart J Case Rep 2022 Mar 21;6(3):ytac105. Epub 2022 Mar 21.

Division of Cardiology, Bluhm Cardiovascular Institute, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Background: Standardized diagnostic criteria for arrhythmogenic left ventricular cardiomyopathy (ALVC) have been recently proposed. The criteria emphasize structural left ventricle (LV) myocardial change on contrast-enhanced imaging and require the identification of gene variants associated with arrhythmogenic cardiomyopathy.

Case Summary: A 21-year-old man presented for evaluation of exertional syncope and was found to have monomorphic ventricular tachycardia (VT) and an episode of polymorphic VT that degenerated to ventricular fibrillatory cardiac arrest. Read More

View Article and Full-Text PDF
March 2022
Similar Publications

Prospective Evaluation of Autonomic Dysfunction in Post-Acute Sequela of COVID-19.

Authors:
Sameer M Jamal David B Landers Steven M Hollenberg Zoltan G Turi Taya V Glotzer Jana Tancredi Joseph E Parrillo

J Am Coll Cardiol 2022 Mar 28. Epub 2022 Mar 28.

Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ.

Background: Patients with PASC often report symptoms of orthostatic intolerance and autonomic dysfunction. Numerous case reports link Postural Orthostatic Tachycardia Syndrome (POTS) to PASC. No prospective analysis has been performed. Read More

View Article and Full-Text PDF
March 2022
Similar Publications

Stress-Induced Cardiomyopathy Raising Concern for Myocardial Ischemia.

Authors:
Arminder Singh Stephanie Everest Lam Nguyen Bradley Casey Manoj Bhandari

Cureus 2022 Feb 10;14(2):e22091. Epub 2022 Feb 10.

Cardiology, Cape Fear Valley Medical Center, Fayetteville, USA.

Stress-induced cardiomyopathy (SIC), or Takotsubo syndrome, is considered a reversible dysfunction of the left ventricle that may mimic an acute coronary syndrome (ACS). Patients may present with chest pain, dyspnea, syncope, or other serious complications including cardiogenic shock, ventricular arrhythmias, and thrombus formation. Diagnostic criteria for SIC include several factors, including electrocardiogram changes, cardiac biomarker elevations, ventricular regional wall abnormalities on echocardiogram, and absence of occlusive coronary disease on coronary angiography. Read More

View Article and Full-Text PDF
February 2022
Similar Publications

Effect of treadmill exercise stress testing on troponin levels in children and adolescents.

Authors:
Anthony G Pompa Gaurav Arora Tyler H Harris

Cardiol Young 2022 Mar 18:1-3. Epub 2022 Mar 18.

Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: Chest pain is a common complaint among paediatric patients and cardiac troponin (cTn) level is often part of the initial emergency department evaluation. It is well known that after intense endurance exercise cTn levels can be elevated in patients with otherwise healthy hearts, however the effect shorter duration exercise has on cTn levels in this population is not known.

Objective: Determine the behaviour of cTn levels in healthy children and adolescent patients after short burst, high-intensity aerobic exercise. Read More

View Article and Full-Text PDF
March 2022
Similar Publications
}