Internal Medicine Flashcard
A man with syncope

https://doi.org/10.1016/j.ejim.2017.07.012Get rights and content

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Indication

A 74-years-old man was admitted at our emergency department for syncope. His past medical history included hypertension, smoking, carotid and peripheral artery disease and hemodialysis for end-stage renal disease. The physical examination revealed aphasia, dysarthria and right-sided motor impairment. The blood pressure was 170/90 mm Hg, heart rate 89 beats per minute, respiratory rate 18 breaths per minute, oxygen saturation 97% in ambient air. Initial basic laboratory values were notable for

Diagnosis

Neurogenic heart syndrome (NHS). The neurogenic myocardial injury is one of the possible complications after acute ischemic stroke. The patho-physiological mechanisms may be related to exaggerated stress-induced release of catecholamines with subsequent acute imbalance of autonomic control of the heart [1]. The autonomic imbalance may lead to hypercontraction of sarcomeres, cardiac stunning, coronary vasospasm, ECG and left ventricular wall motion abnormalities and life-threatening arrhythmias

Conflict of interest

We report no conflict of interest.

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