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[Syncope of undetermined origin].

J P Berger¹, F Delacrétaz

¹Département de médecine interne, Centre hospitalier universitaire vaudois, Lausanne.

Schweizerische Medizinische Wochenschrift

|December 26, 1987

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A sudden onset of chest pressure and shortness of breath in a middle-aged man was diagnosed via biopsy after initial tests were inconclusive. This case highlights the importance of further investigation for unexplained syncopal episodes.

Area of Science:

Cardiology
Pulmonology
Pathology

Background:

A 48-year-old male with no prior medical history presented with acute thoracic pressure and dyspnea.
Symptoms progressed to loss of consciousness without seizure, prompting immediate hospitalization.

Observation:

Physical examination revealed moderate cyanosis and erythematous skin lesions.
Laboratory results indicated moderate hypoxemia and compensated metabolic acidosis.
Chest X-ray showed a small band of left lower lobe atelectasis.

Findings:

Electrocardiogram (ECG), 24-hour Holter monitoring, and pulmonary scintigraphy were unremarkable.
The patient experienced recurrent syncopal attacks with no identifiable cause.
Diagnosis was established through two biopsy procedures.

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Implications:

This case underscores the diagnostic challenges in patients presenting with sudden syncope and cardiorespiratory symptoms.
Biopsy confirmation was crucial in establishing the final diagnosis after non-invasive investigations yielded normal results.
Further research may elucidate the underlying etiology and optimal management strategies for similar presentations.