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Idiopathic hypertrophic subaortic stenosis presenting as cough syncope
Chest
|August 1, 1975
Summary
Severe cough paroxysms caused syncope in a patient with idiopathic hypertrophic subaortic stenosis (IHSS). Propranolol treatment effectively prevented these episodes by reducing pressure gradients and aiding aortic pressure recovery.
Area of Science:
- Cardiology
- Nephrology
Background:
- Idiopathic hypertrophic subaortic stenosis (IHSS) is a complex cardiac condition.
- Syncope, or fainting, can be a debilitating symptom in IHSS patients.
Purpose of the Study:
- To investigate the mechanism of post-tussive syncope in IHSS.
- To evaluate the efficacy of propranolol in managing syncopal episodes related to coughing.
Main Methods:
- Case study of a patient with IHSS experiencing syncope.
- Pharmacological intervention with propranolol.
Main Results:
- Severe cough paroxysms induced sustained decreases in aortic pressure.
- Propranolol effectively abolished syncopal episodes.
- The drug reduced the post-tussive gradient and accelerated aortic pressure normalization.
Conclusions:
- Post-tussive syncope in IHSS can stem from intense coughs and sympathetic stimulation.
- Propranolol is an effective treatment for this specific type of syncope in IHSS.