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Malignant Cough Syncope from Idiopathic Vagal Inflammation
Andrea Farina1, Giorgio Bassanelli1, Alfredo Bianchi1
1Department of Cardiology, A. Manzoni Hospital, Lecco, Italy.
European Journal of Case Reports in Internal Medicine
|February 14, 2019
Summary
Malignant vasodepressive cough syncope, a rare condition, was successfully treated with steroids. This case highlights left vagal neuritis as a potential cause of recurrent loss of consciousness, especially when triggered by coughing.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Recurrent syncope, particularly when associated with coughing, presents a diagnostic challenge.
- Vasodepressive responses can be triggered by various stimuli, necessitating a thorough etiological investigation.
Purpose of the Study:
- To describe a case of malignant vasodepressive cough syncope.
- To elucidate the underlying pathophysiology of cough-induced syncope.
- To evaluate the efficacy of steroid therapy in managing this condition.
Main Methods:
- Case report detailing a patient with vasodepressive cough syncope.
- Diagnostic workup included laryngoscopy and laryngeal electromyography to assess vagal nerve function.
- Treatment involved systemic steroid administration.
Main Results:
- A vaso-vagal mechanism linked to left vagal neuritis was identified as the cause of syncope.
- The patient experienced complete resolution of syncope following steroid therapy.
- Laryngeal electromyography confirmed left vagal neuritis.
Conclusions:
- Left vagal neuritis is a crucial consideration in the differential diagnosis of recent-onset, repetitive syncope, especially if cough-related.
- Systemic steroid therapy offers a successful treatment option for cough-related syncope.
- Prompt consideration of conditions like vagal neuritis may obviate the need for extensive and potentially invasive investigations.
