Pulmonary Embolism in Patients With Syncope

Goldhaber, Samuel Z.

doi:10.1016/j.jacc.2019.04.070

Cited by 2 publications

(1 citation statement)

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“…Despite the absence of chest pain or shortness of breath, the patient suffered from recurrent syncope due to bradycardia. In one series of angiographically confirmed cases of PE, it was discovered that 13% of the patients experienced an episode of syncope ( 5 , 6 ). Of these, more than 80% had a massive embolism, defined as an obstruction of 50% of the pulmonary circulation.…”

Section: Discussionmentioning

confidence: 99%

Case report: An elderly woman with recurrent syncope after pacemaker implantation

Sun

Li²,

Huang³

et al. 2023

Front. Cardiovasc. Med.

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Syncope caused by atrioventricular block may occur as a result of a cardiac vasodepressor reflex. This article reports on a case of recurrent syncope in an 80-year-old woman with high-grade atrioventricular block, documented by electrocardiographic monitoring after pacemaker implantation. Pacemaker testing revealed stable impedance and sensing but a clear increase in the ventricular capture threshold at outputs. This case is unusual because the patient's primary diagnosis was non-cardiac. However, a combination of high D-dimer, hypoxemia, and computerized tomography scan of the pulmonary artery confirmed the diagnosis of pulmonary embolism (PE). With 1 month of anticoagulant therapy, the ventricular capture threshold gradually dropped to the normal range and syncope resolved. This is the first report of an electrophysiological phenomenon detected by pacemaker testing in a patient with syncope arising from PE.

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Section: Discussionmentioning

confidence: 99%