• Rita Khadka, Rajiv Narang, Ashok Kumar Jaryal, Chetan Patel, and Kishore Kumar Deepak.
• Department of Basic and Clinical Physiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
• JNMA J Nepal Med Assoc. 2020 Apr 30; 58 (224): 261-264.

AbstractAngina is a type of chest pain, experienced by patients with ischemic heart diseases. Cardiac autonomic modulation as assessed by heart rate variability and baroreflex sensitivity is found reduced in ischemic heart disease patients. Marked reduction in heart rate variability and baroreflex sensitivity in ischemic heart disease patients is found associated with sudden cardiac death. We report a case of a 35-year-old man who presented with angina for the last few months. Thorough investigations showed no evidence of any cardiac or other systemic diseases. However, his cardiovascular autonomic modulation (as assessed by heart rate variability) and spontaneous baroreflex sensitivity were markedly reduced. The patient had sudden death within 6 months of follow-up. Reportedly, no other specific abnormalities were found before death. This case report suggests that patients presenting with typical chest pain as angina may have severe dysautonomia and risk of sudden death even in the absence of cardiovascular or any other known end-organ diseases.

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