[Syncopal bradyarrhythmias during acute myocardial ischemia without chest pain (author's transl)]

A patient admitted for evaluation of repeated episodes of faintness not associated with chest pain is presented. The episodes were caused by marked sinus bradyarrhythmias secondary to ischemic attacks with inferior ST-segment elevation, no accompanied by anginal pain. Medical treatment with nifedipine was able to prevent both the ischemic attacks and cardiac rhythm disturbances associated with acute ischemia. This case shows that ischemic pathogenesis of syncopal attacks should not be ruled out even in the absence of chest pain and that the attacks may be prevented by treating their primary cause.