A rare cause of syncope in a young female

Published: 26 August 2016
Author(s): Jim X. Liu, Anjali A. Satoskar, Konstantinos Dean Boudoulas
Issue: August 2016
Section: Internal Medicine Flashcard

A 39year-old female with one-week history of chills, night sweats and myalgias presented after a syncopal episode. Physical examination was unremarkable and electrocardiogram showed normal sinus rhythm with left bundle branch block. Troponin I (7.39ng/mL), erythrocyte sedimentation rate (96mm/h) and C-reactive protein (74.8mg/L) were elevated. Shortly after admission, another syncopal episode occurred associated with complete atrioventricular (AV) block (Fig. 1A) followed by ventricular escape rhythm (Fig.