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Troponin release after exertional vasovagal syncope
Olivia Quinn1, David Jardine1, Christopher Florkowski2
1Department of General Medicine, Christchurch Hospital, Christchurch, New Zealand.
Internal Medicine Journal
|August 7, 2019
Summary
Exertional vasovagal syncope can cause troponin release, a previously unreported finding. Intense cardiovagal activity during syncope recovery may lead to myocardial injury markers.
Area of Science:
- Cardiology
- Neurocardiology
- Sports Medicine
Background:
- Exertional syncope is a common clinical presentation.
- Vasovagal syncope is a neurally mediated reflex causing transient hypotension and bradycardia.
- Troponin elevation typically indicates myocardial infarction.
Observation:
- A young male patient experienced recurrent exertional syncope.
- Each syncopal episode was followed by a significant increase in troponin I levels.
- Treadmill testing reproduced symptoms, confirming a vasovagal mechanism.
Findings:
- The patient exhibited prolonged hypotension, bradycardia, and ST depression post-syncope.
- Troponin I levels spiked 10-fold over 24 hours after exertional vasovagal syncope.
- This suggests a link between intense cardiovagal activity and myocardial injury markers.
Implications:
- This case highlights a novel association between exertional vasovagal syncope and troponin release.
- It suggests that significant cardiovagal stimulation can precipitate myocardial injury.
- Further research is needed to elucidate the mechanisms and clinical significance of troponin elevation in vasovagal syncope.
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