Clinical features of cough syncope: a systematic review.
Yanqin Fan, Meng Hou, Haili Wang et al.
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Case in brief
The article presents five cases of cough syncope and reviews published clinical characteristics, comprising 60 patients with a mean age of 56 ± 15 years; 91% were male. Pulmonary infections (35%) and bronchitis (22%) were common underlying triggers, and severe coughing directly precipitated episodes in 93% (26/28) of patients. Limb convulsions accompanied syncope in 22%. Symptoms improved after treatment in 98% of cases. At a median follow-up of 3.75 months (Interquartile Range: 2-12 months), syncope had recurred in 11%.
What made this case unusual
Limb convulsions accompanied syncope in 22% of patients, a feature that may complicate recognition of cough syncope.
Diagnostic / clinical pearl
In a patient with transient loss of consciousness, establish whether severe coughing immediately precedes the episode; convulsive limb movements can also occur with cough syncope.
Why it matters
Syncope recurred in 11% during follow-up, and the authors note the risk of recurrent episodes and falls.