Lifestyle Effects on an Unusual Presentation of Syncope: A Case Report
Speaker Credentials
OMS-IV
College
Dr. Kiran C. Patel College of Osteopathic Medicine, DO
Medical Specialty
Internal Medicine
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
1
Abstract
Introduction: This case study explores a unique presentation of syncope with a multifactorial etiology and discusses the impact of lifestyle behaviors on syncope exacerbation. Scant literature exists on behavioral modifications affecting cardiogenic responses. Case Presentation: We present a 53 year old Hispanic male with a past history of palpitations and chronic marijuana use coming to the emergency department (ED) with three episodes of sudden loss of consciousness that occurred after starting his job as a night shift worker, which led to severe chronic sleep deprivation. These episodes lacked prodromal (chest pain, shortness of breath, palpitations, diaphoresis) and postictal (drowsiness, nausea, confusion, hypertension, headache) symptoms. Electrocardiograms (EKG) performed in the ED revealed sinus bradycardia with a heart rate of 54 beats per minute (bpm). During admission, overnight telemetry exhibited sinus pauses, and repeat EKG showed an incomplete right bundle branch block (RBBB). Patient received a final diagnosis of recurrent syncope and was given an implantable loop recorder (ILR). The ILR revealed several sinus pauses over the span of 3 months with no syncopal episodes. Deviation From the Expected: Marijuana and sleep disruption augmenting parasympathetic cardiac reflexes is not well studied, but a temporal connection can be made to demonstrate a possible causal relationship in the patient. Discussion: Patient was educated on dietary and lifestyle modifications to reduce the risk of experiencing syncopal episodes. Conclusion: Marijuana and disordered sleep from nocturnal shift work can affect cardiac parasympathetic output, culminating in syncope. This study will promote awareness on sleep hygiene and abstinence from Cannabis use in patients with recurrent syncope. Grants: none.
Lifestyle Effects on an Unusual Presentation of Syncope: A Case Report
Introduction: This case study explores a unique presentation of syncope with a multifactorial etiology and discusses the impact of lifestyle behaviors on syncope exacerbation. Scant literature exists on behavioral modifications affecting cardiogenic responses. Case Presentation: We present a 53 year old Hispanic male with a past history of palpitations and chronic marijuana use coming to the emergency department (ED) with three episodes of sudden loss of consciousness that occurred after starting his job as a night shift worker, which led to severe chronic sleep deprivation. These episodes lacked prodromal (chest pain, shortness of breath, palpitations, diaphoresis) and postictal (drowsiness, nausea, confusion, hypertension, headache) symptoms. Electrocardiograms (EKG) performed in the ED revealed sinus bradycardia with a heart rate of 54 beats per minute (bpm). During admission, overnight telemetry exhibited sinus pauses, and repeat EKG showed an incomplete right bundle branch block (RBBB). Patient received a final diagnosis of recurrent syncope and was given an implantable loop recorder (ILR). The ILR revealed several sinus pauses over the span of 3 months with no syncopal episodes. Deviation From the Expected: Marijuana and sleep disruption augmenting parasympathetic cardiac reflexes is not well studied, but a temporal connection can be made to demonstrate a possible causal relationship in the patient. Discussion: Patient was educated on dietary and lifestyle modifications to reduce the risk of experiencing syncopal episodes. Conclusion: Marijuana and disordered sleep from nocturnal shift work can affect cardiac parasympathetic output, culminating in syncope. This study will promote awareness on sleep hygiene and abstinence from Cannabis use in patients with recurrent syncope. Grants: none.