Key result
LAD PTCA successfully treats recurrent exercise-induced syncope in severe CAD.
Why the study?
There is a need for high index of suspicion in diagnosing coronary artery disease in patients presenting with syncope due to rising cardiac death rates.
Case Report (n=1)
No
Coronary artery disease should be considered in the differential diagnosis of recurrent exercise-induced syncope, even in patients without traditional cardiovascular risk factors.
Post-syncopal anterior T-wave inversions warrant coronary evaluation in exercise-induced syncope; leaves open the pattern's diagnostic reliability in low-risk patients.
A 45-year old normotensive, euglycaemic, non-smoker was referred from a peripheral hospital to the Cardiology unit of the University College Hospital, Nigeria for evaluation of recurrent exercise induced syncope. Initial 12-lead electrocardiogram (ECG), 24-hr ambulatory ECG, trans-thoracic echocardiogram and electroencephalogram (EEG) were normal. A repeat episode of syncope warranted further investigation. Immediate post syncope ECG showed deeply inverted symmetrical T waves in the anterior leads. He underwent coronary angiogram which revealed distal left main disease and 70-80% stenosis of the proximal Left Anterior Descending Artery (LAD). The Circumflex artery was non dominant with normal Right Coronary artery. He subsequently had Percutaneous Transluminal Coronary Angioplasty (PTCA) of the LAD. Post-revascularisation course has been satisfactory with no recurrence of syncope. In view of the rising trend of cardiac death in the country, there is the need for high index of suspicion in making diagnosis of coronary artery disease in patients with syncope.
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Adeoye et al. (2013) conducted a case report in Recurrent syncope / Coronary artery disease (n=1). Percutaneous Transluminal Coronary Angioplasty (PTCA) was evaluated on Recurrence of syncope. Percutaneous Transluminal Coronary Angioplasty of the LAD successfully treated recurrent exercise-induced syncope in a 45-year-old man with severe coronary artery disease.
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