Syncope in an adult with uncontrolled asthma

Cough syncope occurs primarily in middle-aged male smokers with chronic obstructive pulmonary disease (COPD). It has also been described in children with asthma. I report the case of a 34-year-old nonsmoker who had syncope due to coughing, and who also related a 1-year history of cough with wheezing. Chest examination revealed diffuse wheezing and a prolonged expiratory phase, and pulmonary function testing with a methacholine challenge confirmed hyperreactive airways. Notably, while undergoing spirometric testing he had a recurrent syncopal episode. His syncope resolved with medical therapy for asthma.