Syncope in Patient with Long-Standing Hypertension, Diabetes, and Mild Aortic Stenosis

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Long-standing hypertension, diabetes, and aortic stenosis are common comorbidities.
• Syncope can be a disabling symptom, particularly in patients with cardiovascular risk factors.
• Intra-His block is a rare but serious conduction abnormality.

Purpose of the Study:

• To present a case study of syncope in a patient with multiple comorbidities.
• To highlight the diagnostic utility of electrophysiology in identifying conduction abnormalities.
• To demonstrate the therapeutic efficacy of permanent pacemaker implantation.

Main Methods:

• Case report of a patient with a history of hypertension, diabetes, and aortic stenosis.
• Diagnostic workup including electrophysiology study.
• Intervention with permanent pacemaker placement.

Main Results:

• Electrophysiology confirmed intra-His block as the cause of syncope.
• Permanent pacemaker implantation successfully eliminated syncopal episodes.
• Improved control of pre-existing hypertension was observed post-pacemaker placement.

Conclusions:

• Intra-His block should be considered in patients with syncope and cardiovascular risk factors.
• Permanent pacemaker implantation is an effective treatment for syncope caused by intra-His block.
• Pacemaker therapy may positively impact comorbid conditions like hypertension.