Why the study?
Defining the etiology of syncope can be challenging, and syncope as the initial presentation of advanced CAD without classic ischemic symptoms is uncommon.
Syncope can rarely be the sole initial presentation of severe multi-vessel coronary artery disease in the absence of classic ischemic symptoms.
Exertional syncope may signal occult severe CAD; this case report leaves open its true prevalence and screening value.
Defining the etiology of syncope can be occasionally challenging. We present a case with no history of coronary artery disease (CAD) who presented exclusively with exertional syncope, and was found to have mildly reduced left ventricular systolic dysfunction on echocardiogram and severe multi-vessel CAD with chronic total occlusion (CTO) of the right coronary artery (RCA). Syncope as the initial presentation of advanced CAD in the absence of classic ischemic symptoms is rather an uncommon presentation in clinical practice.
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Mostafa et al. (2023) studied this question.
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