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2000
Volume 21, Issue 6
  • ISSN: 1573-403X
  • E-ISSN: 1875-6557

Abstract

Background/Introduction

The misdiagnosis of seizure disorders in patients with cardiogenic syncope and tachy-bradyarrhythmias is a significant diagnostic challenge as the differentials for altered mental status and syncope are broad and can mimic other clinical conditions. This case report presents a unique case of an elderly male with life-threatening ventricular arrhythmia, initially misdiagnosed as a seizure disorder associated with syncope and treated with anti-epileptics for a neurogenic cause, before an ambulatory cardiac monitor revealed a sinister cardiogenic etiology.

Case Presentation

An 87-year-old man with ischemic cardiomyopathy (LVEF 20%) and persistent atrial fibrillation presented for implantable cardioverter-defibrillator (ICD) evaluation following a ventricular fibrillation (VF) arrest. He had a history of recurrent syncope accompanied by muscle jerking and was initially treated with anti-epileptic drugs. However, further evaluation with mobile telemetry revealed ventricular arrhythmias, including nonsustained VT, VF, and asystole. Anti-epileptic medications were discontinued, and the patient was started on amiodarone. A cardiac resynchronization therapy defibrillator (CRT-D) was implanted, which successfully resolved his symptoms. Post-treatment, he remained asymptomatic, with no new VT/VF episodes detected at one week and three months during follow-up device checks.

Conclusion

This case underscores the importance of considering cardiogenic causes in patients with syncope and seizure-like symptoms. Therefore, a multidisciplinary approach is essential for accurate diagnosis and management.

© 2025 Bentham Science Publishers
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2025-03-20
2025-10-12

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Unveiling the Hidden Culprit: A Case Report on Tachy-Bradyarrhythmias Presenting as Seizure Disorders
Curr. Cardiol. Rev. 21, e1573403X344795 (2025); https://doi.org/10.2174/011573403X344795250304084151
/content/journals/ccr/10.2174/011573403X344795250304084151
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  • Article Type:     Case Report
Keyword(s): Arrhythmia; atrial fibrillation; cardiogenic syncope; seizures; syncope; tachy-bradyarrhythmia; ventricular fibrillation

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