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Related Experiment Videos

Cough syncope due to atrio-ventricular conduction block

D Saito, S Matsuno, K Matsushita

    Japanese Heart Journal
    |November 1, 1982
    PubMed
    Summary

    Coughing can trigger heart rhythm problems, leading to syncope (fainting). This study found that a hypersensitive broncho-pulmonary reflex caused by coughing induced heart block and fainting in a patient, resolved by pacing.

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    Area of Science:

    • Cardiology
    • Neurology
    • Pulmonology

    Background:

    • Cough syncope is a rare condition where coughing causes temporary loss of consciousness.
    • The underlying mechanisms, particularly the role of reflex pathways, are not fully understood.

    Observation:

    • A patient presented with recurrent episodes of lightheadedness and syncope specifically triggered by coughing.
    • These symptoms were not elicited by other common autonomic stimulation tests like carotid sinus massage or Valsalva maneuver.
    • The patient exhibited transient atrioventricular (A-V) conduction block during coughing episodes.

    Findings:

    • Coughing induced significant atrioventricular (A-V) conduction block and syncope in the patient.
    • The absence of syncope with other stimuli suggests a specific cough-induced reflex pathway.

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  • Permanent right-ventricular pacing completely eliminated the cough-induced syncope and A-V conduction block.

    • Implications:

    • This case highlights a hypersensitive broncho-pulmonary reflex to coughing as a potential cause of A-V conduction block and syncope.
    • Understanding these reflex mechanisms is crucial for diagnosing and managing rare causes of syncope.
    • Pacemaker implantation can be an effective treatment for refractory cough syncope linked to cardiac conduction abnormalities.