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Vasodepressor Cough Syncope Masked by Sleep Apnea‐Induced Asystole
Author(s) -
DICKINSON OANA,
NIJJAR PRABHJOT S.,
DETLOFF BARRY L.S.,
BENDITT DAVID G.
Publication year - 2012
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2012.02305.x
Subject(s) - medicine , asystole , syncope (phonology) , cough reflex , anesthesia , apnea , reflex , sleep apnea , bradycardia , cardiology , intensive care medicine , heart rate , blood pressure
Vasodepressor Cough Syncope . Cough syncope is classified among the neural‐reflex “situational” faints, but whether the clinical consequences in affected individuals result from reflex triggered bradyarrhythmia or vasodepressor‐induced hypotension, or both, is often unknown. In this report we describe findings in a patient with a clinical history consistent with cough syncope, and in whom documented multiple asystolic spells were at first believed to be responsible for symptoms. However, pacemaker therapy initiated at an outside facility failed to suppress symptoms, and subsequent referral for more detailed autonomic study revealed the asystole to be due to sleep apnea, whereas cough‐induced vasodepressor hypotension was the basis of syncope in this individual; the latter provided a pathophysiologic target for prevention of recurring symptoms. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1024‐1027, September 2012)