Recurrent syncope due to ischemic ventricular tachycardia masquerading as a seizure disorder treated with coronary...

Syncope has many possible causes, and its diagnosis depends on a thorough clinical history supported by targeted investigations. Ventricular tachycardia is an important but often overlooked cause, particularly in patients with ischemic heart disease, where timely diagnosis allows for potentially curative interventions.

A 52-year-old Black Ethiopian woman had recurrent syncope initially misdiagnosed as a seizure disorder. Ambulatory electrocardiography revealed sustained monomorphic ventricular tachycardia. Coronary angiography demonstrated critical mid-left anterior descending artery stenosis. She underwent percutaneous coronary intervention and commenced long-term oral amiodarone. During over one year of follow-up, she remained free of syncope.

This case highlights ischaemia-associated ventricular tachycardia as a potentially reversible cause of syncope that may mimic seizures. Improvement was observed after revascularization, though the mechanism remains inferred and may have been influenced by concomitant amiodarone. Clinicians should consider cardiac arrhythmias in atypical seizure-like episodes, especially in adults with cardiovascular risk factors.