Complete ventricular asystole in a patient with altered mental status

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Recurrent syncope is a concerning symptom that can indicate serious underlying cardiac conditions.
• Undiagnosed conduction system disease poses a risk of progression and adverse events.

Observation:

• A patient presented with recurrent syncope and electrocardiogram findings of complete heart block.
• The patient's condition worsened, leading to complete ventricular asystole despite preserved atrial function.

Findings:

• Complete heart block can rapidly progress to asystole, a life-threatening arrhythmia.
• Transvenous cardiac pacing is an effective intervention for managing symptomatic bradycardia and asystole.

Implications:

• Early recognition of syncope as a potential sign of conduction disease is vital.
• Timely cardiac pacing can prevent syncope-related morbidity and mortality.
• This case highlights the importance of cardiac evaluation in patients with recurrent unexplained syncope.