Skip to main content

Advertisement

Log in

An uncommon cause of syncope

  • IM - CASE RECORD
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

The authors present a case of a man with recurrent syncopal episodes. The patient had been hospitalized twice before reaching a correct diagnosis. The syncope was originally ascribed to a sick sinus syndrome, which led to pacemaker implantation. Nonetheless, the patient relapsed with no evidence of pacemaker dysfunction, and was readmitted to the hospital where the likely cause for his symptoms was identified: an adenocarcinoma of the lung infiltrating the vagus and recurrent laryngeal nerves. No further syncopal episodes occurred after thoracic surgery. This syncope led to an early diagnosis of lung cancer leading to appropriate and life extending treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Task Force for the Diagnosis and Management of Syncope, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA, Heart Rhythm Society (HRS), Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, Deharo JC, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Ruiz Granell R, Sarasin F, Ungar A, van Dijk JG, Walma EP, Wieling W (2009) Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 30(21):2631–2671

    Article  Google Scholar 

  2. Brignole M, Ungar A, Bartoletti A, Ponassi I, Lagi A, Mussi C, Ribani MA, Tava G, Disertori M, Quartieri F, Alboni P, Raviele A, Ammirati F, Scivales A, De Santo T (2006) Standardized-care pathway vs. usual management of syncope patients presenting as emergencies at general hospitals. Evaluation of Guidelines in Syncope Study 2 (EGSYS-2) GROUP. Europace 8(8):644–650

    Article  PubMed  Google Scholar 

  3. Del Rosso A, Ungar A, Maggi R, Giada F, Petix NR, De Santo T, Menozzi C, Brignole M (2008) Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Heart 94(12):1620–1626

    Article  PubMed  Google Scholar 

  4. Parry SW, Matthews IG (2013) Update on the role of pacemaker therapy in vasovagal syncope and carotid sinus syndrome. Prog Cardiovasc Dis 55(4):434–442

    Article  PubMed  Google Scholar 

  5. Kronborg MB, Nielsen JC (2012) Pacing in sinus node disease to prevent atrial fibrillation. Expert Rev Cardiovasc Ther 10(7):851–858. doi:10.1586/erc.12.79

    Article  CAS  PubMed  Google Scholar 

  6. Semelka M, Gera J, Usman S (2013) Sick sinus syndrome: a review. Am Fam Physician 87(10):691–696

    PubMed  Google Scholar 

  7. Dicpinigaitis PV, Lim L, Farmakidis C (2014) Cough syncope. Respir Med 108(2):244–251. doi:10.1016/j.rmed.20113.10.020

    Article  PubMed  Google Scholar 

  8. Salo LM, Woods RL, Anderson CR, McAllen RM (2007) Nonuniformity in the von Bezold–Jarisch reflex. Am J Physiol Regul Integr Comp Physiol 293(2):R714–R720

    Article  CAS  PubMed  Google Scholar 

  9. Madden KM, Lockhart C (2009) Arterial baroreflex function in older adults with neurocardiogenic syncope. Clin Invest Med 32(3):E191–E198

    PubMed  PubMed Central  Google Scholar 

  10. International Association for the study of lung cancer (2009) Staging manual in thoracic oncology. Editorial Rx Press, Orange Park

    Google Scholar 

  11. Darnell RB, Posner JB (2011) Paraneoplastic syndromes. Oxford University Press, New York

    Google Scholar 

  12. Patel AK, Yap VU, Fields J, Thomsen JH (1979) Carotid sinus syncope induced by malignant tumors in the neck: emergence of vasodepressor manifestations following pacemaker therapy. Arch Intern Med 139(11):1281–1284

    Article  CAS  PubMed  Google Scholar 

  13. Macdonald DR, Strong E, Nielsen S, Posner JB (1983) Syncope from head and neck cancer. J Neurooncol 1(3):257–267

    Article  CAS  PubMed  Google Scholar 

  14. Chen HY (2012) Recurrent syncope as initial symptom in apical intrathoracic tumor. J Clin Med Res 4(1):77–80

    PubMed  PubMed Central  Google Scholar 

  15. Dubrava J, Drgona L, Kadlecik R (2005) An unusual cause of recurrent syncope: mediastinal lymphoma diagnosed with transesophageal echocardiography. Eur J Intern Med 16(3):204–206

    Article  PubMed  Google Scholar 

  16. Koga T, Kaseda S, Miyazaki N, Kawazoe N, Abe I, Sadoshima S, Onoyama K (2000) Neurally mediated syncope induced by lung cancer: a case report. Angiology 51(3):263–267

    Article  CAS  PubMed  Google Scholar 

  17. Vloka ME, Tamis JE, Steinberg JS (1999) Neurally mediated syncope in 2 patients with extracardiac disease. Arch Intern Med 159(6):625–627

    Article  CAS  PubMed  Google Scholar 

  18. Bassetti CL (2014) Transient loss of consciousness and syncope. Handb Clin Neurol 119:169–191

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Davide Campagna.

Ethics declarations

Conflict of interest

None.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

The patient, who is not identifiable in this paper, gave us consent to deal with his case.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Campagna, D., Amaradio, M.D., Battaglia, E. et al. An uncommon cause of syncope. Intern Emerg Med 11, 425–429 (2016). https://doi.org/10.1007/s11739-015-1317-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-015-1317-2

Keywords

Navigation