Cough-Induced Syncope as an Unusual Manifestation of Pericardial Effusion

El-Osta, Hazem; Ashfaq, Salman

doi:10.17161/kjm.v1i3.11270

Cited by 4 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[12] Our case is the second one and the first one from India of the rare case of cough-induced syncope in a case of pericardial effusion with complete cessation of symptoms post- pericardiocentesis. Thus, we believe that any case of cough-induced syncope needs a low threshold for investigations and a strong consideration to pericardial effusion, which may require drainage though the patient does not show tell-tale signs of cardiac tamponade.…”

Section: Resultsmentioning

confidence: 95%

Unusual presentation of pericardial effusion

Kulkarni¹,

Karnad²

2012

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 95%

Unusual presentation of pericardial effusion

Kulkarni¹,

Karnad²

2012

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…Cough-induced syncope is a well-recognized but uncommon phenomenon in which the cough is the main culprit of the syncope[ 1 ]. It is associated with chronic obstructive pulmonary disease and constrictive pericarditis[ 2 ], although it is very rare to have cough induced syncope in a case of pericardial effusion or cardiac tamponade[ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…In subacute cardiac tamponade, these events occur over days to weeks and is usually associated with neoplastic, uremic or idiopathic pericarditis; it may be asymptomatic early in the course, but once intracardiac pressures reach a critical value, the patients develop symptoms of increased filling pressures and limited cardiac output and syncopal events[ 6 ]. There are two reported cases in the literature of moderate pericardial effusion associated with cough-induced syncope which also presented with pulsus paradoxus with a drop of > 15 mmHg systolic blood pressure but no evidence of echocardiographic criteria for tamponade[ 1 , 3 ]. Pulsus paradoxus greater than 10 mmHg with a pericardial effusion increases the likelihood of tamponade (likelihood ratio, 3.3; 95%CI: 1.8-6.3), while a pulsus paradoxus of 10 mmHg or less lowers the likelihood (likelihood ratio, 0.03; 95%CI: 0.01-0.24)[ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Its sensitivity in identifying right ventricular collapse ranges from 48% to 100% whereas specificity ranges from 72% to 100%[ 9 , 10 ]. In one of the reported cases of cough induced syncope, the pericardial effusion was from metastatic non-small cell carcinoma, while the other case was secondary to suspected viral pericarditis in which pericardiocentesis of both cases afforded complete resolution of cough-syncope syndrome cycle[ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cough induced syncope: A hint to cardiac tamponade diagnosis

Ramírez

Lasam

2017

WJC

View full text Add to dashboard Cite

We report a case of a 75-year-old male with history of lung adenocarcinoma who presented with shortness of breath and frequent episodes of cough-induced syncope. A large pericardial effusion was found on echocardiogram suggestive of cardiac tamponade. Pericardiocentesis was done which improved the dyspnea and eventually resolved the syncope. There are only two other cases reported in the literature with cough-induced syncope in the setting of pericardial effusion or cardiac tamponade. Our clinical vignette also highlights the importance of pulsus paradoxus identification in patients with cough induced syncope to rule out cardiac tamponade since this is the most sensitive physical finding for its diagnosis.

show abstract

“…In some cases, impairment of cerebral venous return causes cerebral hypo perfusion without decrease of systemic blood pressure. Hypoxia due to temporary airway obstruction, acute increase of cerebrovascular resistance during cough seizures and increase of cerebrospinal fluid pressure and reflex cardiac arrhythmias are the other causes proposed for physiopathology [8][9][10][11][12][13] . Syncope generally develops a few seconds after the start of coughing seizures.…”

Section: Discussionmentioning

confidence: 99%

ACE İnhibitörüne Bağlı Öksürük Senkopu

Koç¹,

Peköz²,

Bozdemir³

2015

Cukurova Medical Journal

View full text Add to dashboard Cite

Syncope is defined as a transient loss of consciousness due to sudden temporary decline in cerebral perfusion. Cough syncope is classically seen in middle aged obese men with obstructive pulmonary disease. In patients that use Angiotensin converting enzyme (ACE) inhibitors, a dry persistent cough can emerge due to the side effects of this medication. Seventy years old male patient that use ACE inhibitor for hypertension accepted to the clinic with the complaint of syncope. A bout of coughing has developed during electroencephalography recording and 10 seconds in duration of subcortical like epileptiform discharges were viewed. The ACE inhibitor the patient was receiving was replaced with calcium channel blocker and no complaint was observed during the follow up period. Key words: ACE inhibitor, cough, syncope. ÖZETSenkop, serebral perfüzyonun aniden geçici olarak düşmesiyle ortaya çıkan geçici bilinç kaybı olarak tanımlanır. Obstrüktif akciğer hastalığı olan orta yaşlı obez erkeklerde öksürüğe bağlı senkop klasik olarak görülmektedir. Anjiyotensin konverting enzim (ACE) inhibitörü kullanan hastalarda bu ilacın yan etkisi olarak kalıcı kuru öksürük görülebilmektedir. Hipertansiyon tedavisi için ACE inhibitörü kullanan yetmiş yaşındaki erkek hasta senkop şikayeti ile kliniğe kabul edildi. Elektroensefalografi kaydı sırasında bir öksürük nöbeti gelişti ve süresi 10 saniye olan subkortikal benzeri epileptiform deşarjlar görüldü. Hastanın kullandığı ACE inhibitörü kalsiyum kanal blokörleri ile değiştirildiğinde takip periyodunda herhangi bir komplikasyona rastlanmadı. Anahtar kelimeler: ACE inhibitörü, öksürük, senkop.

show abstract

Cough-Induced Syncope as an Unusual Manifestation of Pericardial Effusion

Cited by 4 publications

References 7 publications

Unusual presentation of pericardial effusion

Unusual presentation of pericardial effusion

Cough induced syncope: A hint to cardiac tamponade diagnosis

ACE İnhibitörüne Bağlı Öksürük Senkopu

Contact Info

Product

Resources

About