Recurrent syncope due to ischemia with non-obstructive coronary artery disease: a case report
Bihan Huang1, Xueying Han2, Peiyi Xie1
1Department of Cardiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China.
Journal of Medical Case Reports
|March 12, 2024
Summary
Ischemia with non-obstructive coronary artery disease (INOCA) can cause recurrent syncope. Early diagnosis and treatment with medications like diltiazem can effectively manage INOCA-related syncope.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- Ischemia with non-obstructive coronary artery disease (INOCA) is a common cause of ischemic heart disease.
- INOCA is often due to coronary microvascular dysfunction (CMD) and/or coronary artery spasm.
- Recurrent syncope is an unusual presentation of INOCA.
Observation:
- A 58-year-old male presented with recurrent syncope.
- Coronary angiography revealed slow flow, suggesting presumptive CMD and coronary artery spasm.
- The patient experienced syncope due to concomitant coronary artery spasm and presumptive CMD.
Findings:
- The patient was treated with diltiazem, nicorandil, and atorvastatin.
- No syncope recurrence was observed during a three-month follow-up.
- Pharmacological management proved effective for INOCA-induced syncope.
Implications:
- This case underscores INOCA as a critical consideration in syncope differential diagnosis.
- Prompt diagnosis of INOCA is essential for effective patient management.
- Recognizing INOCA in syncope cases can improve patient outcomes.
Keywords:
Case reportCoronary artery spasm (CAS)Coronary microvascular dysfunction (CMD)Ischemia and no obstructive coronary artery disease (INOCA)More Related Videos
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