• Jose Mariano T Tan, Hanna S Park, Stephen D Cohle, David J Spurlock, Michael W McNamara, Laura M Franey, and Wissam M Abdallah.
• Division of Cardiovascular Medicine, Michigan State University College of Human Medicine, Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, MI. Electronic address: jose.tan@spectrumhealth.org.
• Chest. 2021 Mar 1; 159 (3): e167-e171.

Case PresentationA 40-year-old woman presented with recurrent syncope. She reported multiple (>20) episodes of non-prodromal loss of consciousness, periodically provoked by physical exertion. One episode resulted in a nasal fracture due to the abrupt nature of her syncope. The characterization of each episode was inconsistent with a neurogenic seizure. Other causes of syncope (vasovagal, situational, carotid hypersensitivity, and orthostasis) were also deemed unlikely. On physical examination, a low-pitched, brief adventitious sound was appreciated after each S2 sound in the right lower sternal border. The remainder of the physical examination was unremarkable. Initial workup, including complete blood count, comprehensive metabolic panel, cardiac enzymes, and ECG yielded normal results. The chest radiograph did not show any gross cardiac or pulmonary parenchymal pathologic condition (Fig 1). Telemetry did not demonstrate any malignant arrhythmias, and video-guided EEG did not document any seizure activity.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

33 keywords...

hide…