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Neurally mediated syncope induced by lung cancer--a case report.
1Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Kitakyushu, Japan.
Angiology
|April 1, 2000
Summary
Lung cancer involving the vagus nerve can cause neurally mediated syncope, characterized by hypotension and bradycardia. Symptoms resolved as other nerve palsies developed, suggesting a transient baroreceptor hypersensitivity.
Area of Science:
- Neurology
- Cardiology
- Oncology
Background:
- Neurally mediated syncope (NMS) is a common cause of fainting, often triggered by autonomic nervous system dysfunction.
- Lung cancer can rarely present with neurological complications affecting autonomic function.
- Understanding the link between lung cancer and NMS is crucial for diagnosis and management.
Observation:
- A patient with lung cancer experienced recurrent episodes of syncope, marked by severe hypotension and bradycardia.
- These episodes occurred in upright positions and were reproducible with a head-up tilt test.
- Syncope resolved spontaneously within two weeks of hospital admission.
Findings:
- The lung cancer was found to involve the afferent vagus nerve, specifically the upper rootlets.
- This involvement is hypothesized to cause transient hypersensitivity of baroreceptor function.
- The hypersensitivity led to the observed episodes of neurally mediated syncope.
Implications:
- This case highlights a rare but significant neurological complication of lung cancer.
- It underscores the importance of considering autonomic dysfunction in cancer patients presenting with syncope.
- Early recognition and management of such complications can improve patient outcomes and quality of life.