Cardiac Syncope with Anoxic Seizure Activity

This is a case report, which explores the presentation to the emergency department of a fit and well female with a known ventricular bigeminy. She presented with convulsive episodes. The working differential diagnosis was of possible cardiac syncope with anoxic seizure activity or neurogenically mediated arrhythmia secondary to subarachnoid haemorrhage. On further collateral history, the patient was on citalopram. The ECGs demonstrated PVCs of multiple morphologies that were transiently bidirectional, raising the possibility of catecholaminergic polymorphic ventricular tachycardia. The presentation of a young fit patient with syncope and seizure-like episodes should always raise concern for the admitting emergency medicine clinician of an underlying cardiac pathology.

这是一份案例报告，探讨了急诊室的表现，并有一个良好的女性，其中有一个已知的心室bigeminy。她介绍了抽搐的情节。工作的鉴别诊断可能具有心脏晕厥，具有缺氧性癫痫活性或继发于蛛网膜下腔出血的神经源性介导的心律不齐。在进一步的抵押历史上，该患者在西妥位丙酰亚醇上。 ECG显示了瞬时双向的多种形态学的PVC，从而增加了儿茶酚胺能多态性心脏心动过速的可能性。向年轻的晕厥和癫痫发作样发作的年轻患者的介绍应始终引起人们对急诊医学临床医生的潜在心脏病理学的关注。