• Am J Emerg Med · Oct 2019

    Case Reports

    A case of elusive cardiac dysrhythmia in high-risk syncope.

    • Yijia Mu and Mark Supino.
    • Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, FL 33139, United States of America.
    • Am J Emerg Med. 2019 Oct 1; 37 (10): 1992.e1-1992.e3.

    AbstractEmergency department presentations of syncope can vary from benign to life-threatening etiologies. Older patients are at increased risk of cardiac causes of syncope. Ventricular standstill is a rare phenomenon that can manifest as syncope and must be correctly identified and promptly treated to prevent sudden cardiac arrest. We report the case of a 70-year old man with dizziness and convulsive syncope whose initial ECG showed a right bundle branch block, but then developed ventricular standstill and intermittent high-grade AV block while still in the ED. He was transferred to the ICU and underwent pacemaker implantation. A high index of suspicion for dysrhythmias should be maintained for any patient presenting to the ED with high-risk syncope.Copyright © 2019 Elsevier Inc. All rights reserved.

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