Syncope in aortic stenosis during continuous electrocardiographic monitoring--a case report

A female patient with severe aortic stenosis had suffered from repeated syncope. Transaortic valve pressure gradient at cardiac catheterization was 117 mmHg. Continuous electrocardiographic monitoring was done after admission. During syncope, the electrocardiogram showed bradycardia with the lowest heart rate 44 beats per minute, while arterial pulses were not palpable. Rather than arrhythmia, other mechanisms, such as an inhibitory reflex from left ventricular receptors, should be postulated as the cause of syncope in patients with severe aortic stenosis.