Related Experiment Video
Updated: May 26, 2026
14:09
Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
An unusual cause of syncope
Priya Nair1, Alan Robertson, Ronald Macwalter
1Ninewells Hospital, Department of Stroke Medicine, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
BMJ Case Reports
|December 16, 2011
Summary
Recurrent syncope in a metallurgist was linked to solvent inhalation and cannabis use in a poorly ventilated workshop. Improving workplace ventilation resolved the syncopal episodes, highlighting the importance of occupational history.
Area of Science:
- Occupational Medicine
- Toxicology
- Cardiology
Background:
- Recurrent syncope can have diverse etiologies, sometimes linked to environmental exposures.
- Occupational and social history are crucial for diagnosing unusual medical conditions.
Purpose of the Study:
- To present an unusual case of recurrent syncope.
- To identify the contributing factors and propose a management strategy.
Main Methods:
- Detailed patient history including occupational and social habits.
- Physical examination and standard cardiac investigations (ECG, 24-hour ECG, echocardiogram).
- Liver biopsy to assess for metabolic injury.
Main Results:
- Patient experienced recurrent syncope in a poorly ventilated workshop with solvent and cannabis use.
- Cardiac investigations were normal; liver biopsy revealed steatohepatitis and cirrhosis.
- Syncope resolved completely after improving workplace ventilation.
Conclusions:
- Solvent inhalation compounded by cannabis use in a poorly ventilated environment can cause syncope.
- Thorough social and occupational history is essential for diagnosing atypical syncope presentations.
- Environmental modifications can effectively manage occupationally-induced syncope.
Related Concept Videos
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
01:29Disturbances in Heart Rhythm
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:28Dysrhythmias II: Classification of Tachyarrhythmias
Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
01:17Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
01:07Narcolepsy
Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
01:14Decreased pulse rate
Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with bradycardia...
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with bradycardia...