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Transient presyncope secondary to posterior descending artery occlusion

Andrew D Moffat1, Jamal T Al-Khatib1, Jennifer Michael1

  • 1Graduate Medical Education Faculty, Kingman Regional Medical Center, 3269 Stockton Hill Road, Kingman, AZ 86409, USA.

Case Reports in Cardiology
|May 15, 2014
PubMed

Insights

A 64-year-old male experienced presyncope and bradycardia due to severe coronary artery disease. Successful percutaneous coronary intervention resolved his symptoms, highlighting the link between coronary blockages and cardiac electrical disturbances.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Coronary artery disease (CAD) can manifest with diverse symptoms, including syncope and bradycardia.
  • Electrocardiogram (ECG) abnormalities like left bundle branch block (LBBB) can be indicative of underlying cardiac conditions.

Observation:

  • A 64-year-old male presented with presyncope and bradycardia, lacking typical anginal chest pain.
  • A stress test revealed a new-onset left bundle branch block and premature ventricular contractions, despite no induced physical symptoms.

Findings:

  • Coronary angiography demonstrated severe obstructive disease in multiple coronary arteries.
  • Percutaneous coronary intervention (PCI) was performed in two separate procedures.
  • Resolution of presyncope and bradycardia occurred following successful reperfusion of the posterior descending artery.

Implications:

  • This case underscores the importance of investigating cardiac electrical abnormalities in patients with unexplained syncope, even without ischemic symptoms.
  • Successful revascularization can effectively treat bradyarrhythmias and presyncope caused by significant coronary artery disease.
  • Highlights the potential for severe CAD to present atypically, emphasizing comprehensive diagnostic approaches.

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