Exertional syncope in a patient with aortic stenosis and right coronary artery disease

A female with advanced aortic valvular stenosis and moderate right coronary artery disease experienced an exertional syncope during 24-h ambulatory electrocardiographic monitoring. A progressive bradycardia with 90-s sinus node arrest (cardio-inhibitory response) and premonitory angina pectoris with...

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Bibliographic Details
Published in:European heart journal 1995-02, Vol.16 (2), p.276-278
Main Authors: SINKOVEC, M, RAKOVEC, P, ZORMAN, D, ANTOLIC, G, GRAD, A
Format: Article
Language:English
Subjects:
Aged
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - physiopathology
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Coronary Disease - complications
Coronary Disease - physiopathology
Electrocardiography, Ambulatory
Female
Heart
Humans
Medical sciences
Physical Exertion
Syncope - etiology
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Summary:A female with advanced aortic valvular stenosis and moderate right coronary artery disease experienced an exertional syncope during 24-h ambulatory electrocardiographic monitoring. A progressive bradycardia with 90-s sinus node arrest (cardio-inhibitory response) and premonitory angina pectoris with significant ST segment changes were demonstrated. Our report supports the concept of a neurocardiogenic (vasovagal) mechanism of exertional syncope in patients with aortic stenosis. The predominant left ventricular inferior-wall myocardial ischaemia in our patient might be an additional stimulus to left ventricular mechanoreceptors, resulting in a profound cardio-inhibitory response.
ISSN:0195-668X
1522-9645
DOI:10.1093/oxfordjournals.eurheartj.a060896