An unusual cause of blackout with transient loss of consciousness: Prinzmetal angina

BMJ Case Rep. 2012 Jun 14:2012:bcr0120125539. doi: 10.1136/bcr.01.2012.5539.

Abstract

The authors present the case of a 61-year-old woman who was troubled by regular episodes of throat discomfort, headache, dyspnoea and tingling sensation in the upper limbs. These were associated with occasional episodes of transient loss of consciousness accompanied by urinary incontinence over a period of 5 years. As these episodes became increasingly frequent, she was referred to a neurologist. Initial neurological assessment and investigations had a negative diagnostic yield and she was therefore referred for cardiac review. A repeat 24 h Holter revealed intermittent episodes of significant ST-segment elevation associated with a Mobitz type II atrio-ventricular block correlating with her symptoms. Her echocardiography and coronary angiography were normal; hence a diagnosis of Prinzmetal angina was made. She was treated appropriately with nitrates and a calcium channel blocker and followed up in cardiology clinic with no further recurrence of symptoms.

Publication types

  • Case Reports

MeSH terms

  • Angina Pectoris, Variant / complications*
  • Angina Pectoris, Variant / diagnosis
  • Angina Pectoris, Variant / physiopathology
  • Consciousness*
  • Coronary Angiography
  • Diagnosis, Differential
  • Electrocardiography
  • Female
  • Humans
  • Middle Aged
  • Syncope / complications*
  • Syncope / diagnosis
  • Syncope / physiopathology
  • Unconsciousness / diagnosis
  • Unconsciousness / etiology*
  • Unconsciousness / physiopathology