Abstract Background Recurrent pre-syncope poses diagnostic challenges, especially when associated with gastroesophageal refluxdisease (GERD) and aspergilloma, as described in this case report of a 27-year-old female. Objective This case report aims to highlight the clinical complexity and diagnostic considerations of recurrent pre-syncope in the presence of coexisting gastrointestinal and respiratory conditions. Case Presentation Despite stable vital signs, she presented with episodes of near-fainting exacerbated by ambulation, accompanied by pleuritic chest pain, visual disturbances, and generalized weakness. Past medical history included GERD and prior aspergilloma treatment. Initial investigations revealed mild electrolyte disturbances and elevated troponin I levels, prompting cardiac evaluation, which was normal. Chest imaging confirmed stable aspergilloma. Discussion The absence of definitive cardiac or neurological pathology emphasized the need to explore alternative and multifactorial mechanisms. While the direct link between GERD, aspergilloma, and syncope remains unclear, the potential for vagal stimulation and chronic respiratory compromise underscores the need for comprehensive evaluation. Conclusion This case report underscores the importance of a broad differential diagnosis, avoidance of premature diagnostic closure, and recognition of non-cardiac contributors to recurrent pre-syncope in young patients. It also highlights the importance of considering multifactorial etiologies in recurrent pre-syncope, urging further research for targeted interventions.
Alghamdi et al. (Thu,) studied this question.