Skobel E, Bell A, Nguyen DQ, Woehrle H, Dreher M. Trauma and syncope-evidence for further sleep study? A case report. World J Cardiol 2015; 7(3): 161-166 [PMID: 25810817 DOI: 10.4330/wjc.v7.i3.161]
Corresponding Author of This Article
Erik Skobel, MD, Head of Department, Clinic for Cardiac and Pulmonary Rehabilitation, “An der Rosenquelle”, Kurbrunnenstraße 5, 52077 Aachen, Germany. erik.skobel@rosenquelle.de
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Mar 26, 2015; 7(3): 161-166 Published online Mar 26, 2015. doi: 10.4330/wjc.v7.i3.161
Trauma and syncope-evidence for further sleep study? A case report
Erik Skobel, Andreas Bell, Dang Quan Nguyen, Holger Woehrle, Michael Dreher
Erik Skobel, Clinic for Cardiac and Pulmonary Rehabilitation, “An der Rosenquelle”, 52077 Aachen, Germany
Andreas Bell, Department of Surgery, Marienhospital, 52077 Aachen, Germany
Dang Quan Nguyen, Department of Internal Medicine, Marienhospital, 52077 Aachen, Germany
Holger Woehrle, Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, 89073 Ulm, Germany
Michael Dreher, Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital, 52077 Aachen, Germany
Author contributions: Skobel E collected the data and wrote the article; Nguyen DQ collected and interpretate the patient´s clinical data; Bell A, Woehrle H and Dreher M revised the article for important clinical content.
Ethics approval: An ethical approval for the case report was not required (ethical review committee number Aachen IORG0006299).
Informed consent: Written informed consent was given by the patient for publication. All procedures conformed to the standards set by the Declaration of Helsinki in its latest revision.
Conflict-of-interest: All authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Erik Skobel, MD, Head of Department, Clinic for Cardiac and Pulmonary Rehabilitation, “An der Rosenquelle”, Kurbrunnenstraße 5, 52077 Aachen, Germany. erik.skobel@rosenquelle.de
Telephone: +49-241-6007501 Fax: +49-241-6007502
Received: September 5, 2014 Peer-review started: September 5, 2014 First decision: November 3, 2014 Revised: December 2, 2014 Accepted: December 16, 2014 Article in press: December 17, 2014 Published online: March 26, 2015 Processing time: 189 Days and 14.5 Hours
Abstract
We report on an 83-year-old male with traumatic brain injury after syncope with a fall in the morning. He had a history of seizures, coronary artery disease and paroxysmal atrial fibrillation (AF). No medical cause for seizures and syncope was determined. During rehabilitation, the patient still complained of seizures, and also reported sleepiness and snoring. Sleep apnea diagnostics revealed obstructive sleep apnea (SA) with an apnea-hypopnoea index of 35/h, and sudden onset of tachycardia with variations of heart rate based on paroxysmal atrial fibrillation. Additional tests showed nocturnal AF which spontaneously converted to sinus rhythm mid-morning with an arrest of 5 s (sick sinus syndrome) and seizures. A DDD-pacer was implanted and no further seizures occurred. SA therapy with nasal continuous positive airway pressure was refused by the patient. Our findings suggests that screening for SA may offer the possibility to reveal causes of syncope and may introduce additional therapeutic options as arrhythmia and SA often occur together which in turn might be responsible for trauma due to syncope episodes.
Core tip: Arrhythmias and sleep apnea should be considered as relevant factors resulting in syncope and trauma in the elderly. This case report applies screening for sleep apnea to detect arrhythmia as a common cause of syncope. Screening for sleep apnea may offer the possibility of additional therapeutic options and diagnostic in trauma and syncope after performing standard diagnostics.
