Cough syncope.

Area of Science:

• Neurology
• Cardiology
• Pulmonology

Background:

• Cough syncope, historically termed "laryngeal vertigo," has been documented since 1876.
• Early theories suggested epilepsy, but consensus shifted to intrathoracic pressure elevation from coughing.
• The typical patient profile is a middle-aged, overweight male with obstructive airways disease.

Purpose of the Study:

• To review the historical understanding and proposed mechanisms of cough syncope.
• To discuss the typical patient profile associated with this condition.
• To emphasize the importance of treating underlying cough causes.

Main Methods:

• Literature review of historical and contemporary case reports and mechanistic studies.
• Analysis of proposed pathophysiological mechanisms, including hemodynamic and neurally mediated responses.
• Synthesis of information from recent cough management guidelines.

Main Results:

• Cough syncope mechanisms are debated, with theories including reduced cardiac output, increased cerebrospinal fluid pressure, or a vasodepressor-bradycardia reflex.
• Elevated intrathoracic pressure during coughing is a common factor.
• Effective management involves identifying and treating the root cause of the cough.

Conclusions:

• Understanding the precise mechanism of cough syncope is ongoing.
• The primary treatment strategy focuses on eliminating the cough reflex by addressing its underlying etiology.
• Management aligns with current cough management guidelines for optimal patient outcomes.