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A 34-year-old man with a history of cough syncope exhibited Mobitz type II atrioventricular block with a narrow QRS complex on Holter monitoring. The baseline electrophysiologic study was normal. No significant atrioventricular block could be induced with carotid sinus massage, neck suction, or intravenous propranolol. However, coughing reproduced Mobitz type II atrioventricular block, which was found to be above the His bundle on the His bundle electrogram. A review of the mechanism of cough syncope is also presented.

Elevated levels >or= 60 mg/dL) of high-density lipoprotein cholesterol have been felt to be protective for cardiovascular disease in women. While cardiovascular disease is the leading killer of women in the United States, this is underrecognized, and women's symptoms are often atypical, leading to underdiagnosis. When high-density lipoprotein cholesterol is high, physicians may underestimate a woman's cardiovascular risk. This tendency may have adverse health consequences.

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