Diaphragmatic Cardiac Compression Mimicking Defecation Syncope: A Case Report
Authors: Yalçin Velibey, Tolga S. Guvenc, Murat Ugur, Ozge Guzelburc, Mehmet Eren
Journal: Annals of Internal Medicine (2016)

Letters20 September 2016Diaphragmatic Cardiac Compression Mimicking Defecation Syncope: A Case ReportYalçin Velibey, MD, Tolga S. Guvenc, MD, Murat Ugur, MD, Ozge Guzelburc, MD, and Mehmet Eren, MDYalçin Velibey, MDFrom Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.Search for more papers by this author, Tolga S. Guvenc, MDFrom Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.Search for more papers by this author, Murat Ugur, MDFrom Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.Search for more papers by this author, Ozge Guzelburc, MDFrom Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.Search for more papers by this author, and Mehmet Eren, MDFrom Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0594 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Identifying the cause of syncope is important. Cardiac syncope has a poor prognosis without treatment, whereas vasovagal syncope and other situational variants of neurocardiogenic syncope have favorable long-term outcomes (1).Objective: To describe a patient with cardiac syncope who seemed to have a situational variant of neurocardiogenic syncope.Case Report: A 23-year-old man was admitted to our hospital after 9 episodes of syncope during defecation in the previous 2 months. Syncopal episodes began 20 months earlier after 2 thoracic surgeries—thoracoscopy to remove a bronchogenic cyst in the left hemithorax adjacent to the lower half of the esophagus and emergent ...References1. Alboni P, Brignole M, Menozzi C, Raviele A, Del Rosso A, Dinelli M, et al. Diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol. 2001;37:1921-8. [PMID: 11401133] CrossrefMedlineGoogle Scholar2. Allan L, Johns E, Doshi M, Anne Kenny R, Newton JL. Abnormalities of sympathetic and parasympathetic autonomic function in subjects with defaecation syncope. Europace. 2004;6:192-8. [PMID: 15121069] CrossrefMedlineGoogle Scholar3. Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, et al. Incidence and prognosis of syncope. N Engl J Med. 2002;347:878-85. [PMID: 12239256] CrossrefMedlineGoogle Scholar4. Middlekauff HR, Stevenson WG, Stevenson LW, Saxon LA. Syncope in advanced heart failure: high risk of sudden death regardless of origin of syncope. J Am Coll Cardiol. 1993;21:110-6. [PMID: 8417050] CrossrefMedlineGoogle Scholar5. Martin TP, Hanusa BH, Kapoor WN. Risk stratification of patients with syncope. Ann Emerg Med. 1997;29:459-66. [PMID: 9095005] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0594.This article was published at www.annals.org on 29 March 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 September 2016Volume 165, Issue 6Page: 454-456KeywordsBlood pressureDefecationHeart diseasesHeart rateInferior vena cavaLeft atriumLeft ventricleRight ventricleSudden cardiac deathSyncope ePublished: 29 March 2016 Issue Published: 20 September 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...