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An uncommon cause of syncope.
Davide Campagna1, Maria Domenica Amaradio2, Eliana Battaglia2
1UOC di Medicina Interna e Medicina d'Urgenza, Edificio 4, Piano 3, AOU ''Policlinico, V. Emanuele'', P.O. "G. Rodolico", Via S. Sofia, 78, 95123, Catania, Italy. davidecampagna83@gmail.com.
Internal and Emergency Medicine
|September 27, 2015
Summary
Recurrent syncope in a patient was initially misdiagnosed as sick sinus syndrome. Correct diagnosis revealed lung adenocarcinoma infiltrating nerves, leading to life-extending treatment after surgery.
Area of Science:
- Neurology
- Oncology
- Cardiology
Background:
- Recurrent syncope presents a diagnostic challenge, often requiring extensive investigation.
- Previous misdiagnosis can lead to inappropriate treatments and delayed definitive care.
Observation:
- A patient experienced recurrent syncopal episodes despite pacemaker implantation for presumed sick sinus syndrome.
- The patient's symptoms persisted, prompting further investigation beyond cardiac causes.
Findings:
- An adenocarcinoma of the lung was identified as the cause of syncope.
- The lung cancer infiltrated the vagus and recurrent laryngeal nerves, explaining the neurological and cardiovascular symptoms.
Implications:
- This case highlights the importance of considering non-cardiac etiologies in refractory syncope.
- Early diagnosis of lung cancer through syncope evaluation can lead to timely, life-extending treatment.
- Vagal nerve involvement in lung cancer can manifest as unexplained syncopal episodes.
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