Positional Syncope Research Articles

Change from Cardioinhibitory Syncope to Iatrogenic Positional Syncope: Superior Vena Cava Syndrome Treated by Superior Vena Cava Stenting and Leadless Pacemaker Implantation

Symptomatic obstruction of the superior vena cava can be caused by either intrathoracic malignancy or nonmalignant etiology, resulting in superior vena cava syndrome (SVCS). The widespread use of central venous catheters, ports, pacemakers, and defibrillators has increased the incidence of benign SVCS. We present a post-pacemaker-implantation case of SVCS manifesting as positional syncope. The percutaneous intervention of stent implantation after lead removal followed by reimplantation of the leadless pacemaker may be a potential alternative treatment for pacemaker-induced SVCS, since some cases eventually may require repeat intervention.

PP-467 - Change from the Cardio-Inhibitory Syncope to İatrogenic Positional Syncope and Micra Leadless Pacemaker Solution With Superior Vena Cava Stenting

Symptomatic obstruction of the superior vena cava (SVC) can be caused by either intrathoracic malignancy or nonmalignant etiology resulting in superior vena cava syndrome (SVCS). The widespread use of central venous catheters, ports, pacemakers, and defibrillators has increased the incidence of benign SVCS.

Transcranial Doppler for Eagle Syndrome: Rare Presentation of Unilateral Internal Carotid Artery Compression by the Stylohyoid Ligament With Provocative Maneuvers

Eagle syndrome is a rare condition caused by compression of the internal carotid artery (ICA) or cranial nerves by an elongated styloid process or calcified stylohyoid ligament. This patient is a 56 year-old woman who presented with episodes of positional syncope for 8 years. Transcranial Doppler (TCD) demonstrated abnormally decreased flow in the left middle cerebral artery (MCA) during the syncopal episodes. The patient was evaluated by TCD, transcranial imaging (TCI), and carotid duplex (CD). First, a baseline CD and TCI were performed with the patient in a neutral position. TCD was then used during symptomatic provocative maneuvers to monitor the bilateral MCAs. Intraoperative TCD monitoring was also done during bilateral stylohyoid ligament resection, and postoperatively during the same provocative maneuvers. The baseline CD examination revealed normal extracranial carotid anatomy; TCD and TCI showed normal mean velocities and a normal anatomic variant of fetal origin of the left posterior cerebral artery. During provocative maneuvers, TCD showed abnormally dampened to absent flow in the left MCA, consistent with compression of the left extracranial ICA. CT scan confirmed elongated stylohyoid ligaments bilaterally. The MCA mean velocities were monitored intraoperatively and postoperatively by TCD and showed no changes with head positioning immediately following resection of the stylohyoid ligaments. The patient reported no syncopal episodes at follow-up 6 days after surgery. Although rare, Eagle syndrome should be considered as a cause of positional syncope. TCD can serve as a diagnostic test, an intraoperative monitoring tool, and a method for documenting the surgical outcome.

Not Quite a Hero (Hemodialysis Reliable Outflow Graft): A Rare Cause of Dyspnea and Positional Syncope in End Stage Renal Disease (ESRD)

Not Quite a Hero (Hemodialysis Reliable Outflow Graft): A Rare Cause of Dyspnea and Positional Syncope in End Stage Renal Disease (ESRD)

Myxomes cardiaques (à propos de 23 cas opérés)

Objective This study aims to report clinical particularities, treatment concepts, potential evolution related to cardiac myxoma to the light of our initial experience and reviewed of the literature. Methods and results Between May 1980 and January 2005: 23 patients were operated in our service for cardiac myxoma. There were 21 left-atrium myxomas and two in right atrium. The mean age was 42.73 years (range 21 to 60 years). The sex-ratio was 2.28 (16 women and seven men). In four cases, the myxomas were chance findings at echocardiography but the 19 symptomatic patients had different symptoms: dyspnea, palpitations, left ventricular failure, positional syncope, systemic embolism, chest pain or right ventricular failure. The diagnostic of myxoma was realized in all cases by echocardiography. The resection of the tumor and a wide part of the inter-atrial septum were performed in all case. The post-operative course was usually uncomplicated: only one patient had double recurrence and died of mediastinitis after the third operation. Conclusion The myxoma is considered to be rare, and remains classical emergency with low operative risk, however the risk of recurrence imposes a long-term follow-up by echocardiography.

Recurrent positional syncope as the primary presentation of superior vena cava syndrome after pacemaker implantation

Recurrent positional syncope as the primary presentation of superior vena cava syndrome after pacemaker implantation

Post-Pneumonectomy Syndrome in an Adult Presenting with Positional Syncope

Post-pneumonectomy syndrome is a rare late complication of pneumonectomy, which is due to extreme mediastinal shift and rotation into the pneumonectomy space. Recurrent syncope following a right pneumonectomy in a 21-year-old woman was treated by insertion of an expandable silicone prosthesis into the pneumonectomy space.