Khalil Kanjwal1, Yousuf Kanjwal, Beverly Karabin, Blair P Grubb. 1. Department of Medicine, Division of Cardiovascular Medicine, Center for Autonomic Disorders, the University of Toledo Medical Center, Toledo, Ohio 43614, USA.
Abstract
INTRODUCTION: In some patients with recurrent syncope, the etiology may remain unclear despite extensive evaluation. These patients may sometimes be labeled as having a "psychogenic" cause for their syncope. METHODS: We report on three patients with recurrent unexplained syncope (despite extensive evaluation) who were labeled as having a psychogenic cause for their events. In each patient following placement of an implantable loop recorder, their syncopal events were found to be due to periods of prolonged asystole and/or complete heart block. One patient had prolonged asystole for 44 seconds. In each patient, episodes of syncope were eliminated following permanent pacemaker implantation. CONCLUSION: We conclude that physicians should exercise great caution before labeling any patient's syncope as psychogenic and that prolonged monitoring may be necessary to exclude a potential cardiac rhythm-related etiology.
INTRODUCTION: In some patients with recurrent syncope, the etiology may remain unclear despite extensive evaluation. These patients may sometimes be labeled as having a "psychogenic" cause for their syncope. METHODS: We report on three patients with recurrent unexplained syncope (despite extensive evaluation) who were labeled as having a psychogenic cause for their events. In each patient following placement of an implantable loop recorder, their syncopal events were found to be due to periods of prolonged asystole and/or complete heart block. One patient had prolonged asystole for 44 seconds. In each patient, episodes of syncope were eliminated following permanent pacemaker implantation. CONCLUSION: We conclude that physicians should exercise great caution before labeling any patient's syncope as psychogenic and that prolonged monitoring may be necessary to exclude a potential cardiac rhythm-related etiology.
Authors: Martijn R Tannemaat; Julius van Niekerk; Robert H Reijntjes; Roland D Thijs; Richard Sutton; J Gert van Dijk Journal: Neurology Date: 2013-07-19 Impact factor: 9.910