engleski

Tussive syncope: case report

Tussive syncope, or cough syncope, is most often found in middle- aged, moderately obese men, who smoke or have stopped smoking. The reason why the male gender and obesity are predisposing factors for cough syncope is unknown. The majority of patients also suffer from chronic cough, episodes of severe cough, and clinical evidence of obstructive pulmonary disease. There are several proposed mechanisms. The first is that when a person coughs, intrathoracic pressure rises and obstructs venous outflow, which results in an acute decrease of cardiac output and blood pressure. As a result, the cerebral flow also decreases, which finally causes loss of consciousness. A second possible mechanism is the decrease of cerebral perfusion, as a consequence of increased pressure of the cerebrospinal liquor. Besides these mechanisms, tussive syncope is also found in patients with hypersensitive carotid sinus syndrome, gastroesophageal reflux, etc. Tussive syncope is considered as one of the situational syncopes, which take place after certain processes: e.g. defecation, micturition, swallowing and coughing. We will present the diagnostic guidelines through the case of a 45 year-old patient with tussive syncope, treated at the Split University Hospital Department for Pulmonary Diseases.

tussive syncope; guidelines

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