ArticleCurrent cardiology reviews2025
Unveiling the Hidden Culprit: A Case Report on Tachy-Bradyarrhythmias Presenting as Seizure Disorders.
Article in Current cardiology reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
introductionThe 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.
conclusionThis 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.
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