Increased syncopal episodes post surgery · Dx?

Area of Science:

• Cardiology
• Pulmonology
• Neurology

Background:

• Vasovagal syncope is a common cause of syncope, typically triggered by various stimuli.
• Pulmonary embolism (PE) is a potentially life-threatening condition often associated with dyspnea and chest pain.

Observation:

• A case is presented where a patient experienced vasovagal syncope as the primary presentation of non-massive pulmonary embolism.
• This highlights an atypical manifestation of PE, challenging conventional diagnostic approaches.

Findings:

• Non-massive pulmonary embolism can precipitate reflex-mediated syncope without the presence of massive embolic burden.
• The vasovagal response may be triggered by the physiological changes associated with PE, even when sub-massive.

Implications:

• Clinicians should maintain a high index of suspicion for pulmonary embolism in patients presenting with vasovagal syncope, particularly those with identified risk factors for venous thromboembolism.
• Integrating PE screening into the syncope workup for at-risk individuals may improve diagnostic accuracy and patient outcomes.
• This case broadens the differential diagnosis for vasovagal syncope, emphasizing the need for comprehensive evaluation beyond typical triggers.