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Recurrent Syncope Associated with Lung Cancer.

Dingguo Zhang1, Liansheng Wang1, Zhijian Yang1

  • 1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu 210029, China.

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This case highlights syncope as a potential symptom of serious coronary heart disease and bronchogenic carcinoma. Prompt diagnosis and treatment of these conditions are crucial for resolving syncope.

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Area of Science:

  • Cardiology
  • Oncology
  • Internal Medicine

Background:

  • Syncope is a common clinical issue with diverse etiologies, often leading to diagnostic challenges.
  • A normal chest X-ray can sometimes obscure serious underlying conditions.
  • Coronary heart disease and bronchogenic carcinoma are significant health concerns.

Purpose of the Study:

  • To report an unusual case of recurrent syncope with a normal initial chest X-ray.
  • To illustrate the diagnostic process involving cardiac and oncologic evaluations.
  • To emphasize the importance of considering multiple potential causes of syncope.

Main Methods:

  • Initial evaluation included a chest X-ray.
  • Diagnostic workup involved exercise electrocardiogram (EKG) and coronary angioplasty.
  • Further investigation utilized tumor markers (cytokeratin-19-fragment, neuron-specific enolase) and enhanced computed tomography (CT) scan.
  • Treatment involved coronary stent transplantation followed by chemotherapy.

Main Results:

  • Coronary heart disease was diagnosed and treated with stent transplantation, but syncope recurred.
  • Elevated tumor markers and CT scan confirmed bronchogenic carcinoma.
  • Chemotherapy effectively eliminated syncope symptoms, indicating the carcinoma as the cause of recurrent episodes.

Conclusions:

  • Recurrent syncope can be a manifestation of serious underlying conditions like coronary heart disease and bronchogenic carcinoma.
  • A systematic diagnostic approach is essential, even with initially normal findings.
  • Effective treatment of bronchogenic carcinoma led to the resolution of syncope in this case.