Headache and sick sinus syndrome:A case report

BACKGROUND Sick sinus syndrome is a common disease in cardiology.Typical symptoms include palpitations,dizziness,shortness of breath,chest tightness,and amaurosis.However,to date,there are no known reports of sick sinus syndrome presenting with headache.Whether there is a correlation between headache and sick sinus syndrome merits further research.In this report,we describe a case of headache induced by sick sinus syndrome.CASE SUMMARY A 73-year-old female patient presented to our department with the chief complaint of recurrent paroxysmal headache for more than 7 years.The patient described paroxysmal palpations,usually headache occurring after palpitation.Her blood pressure was normal when the most recent headache occurred.A magnetic resonance imaging study and magnetic resonance angiography of the head at another center were normal.A clinical neurological examination was negative.A 24-h Holter electrocardiogram monitoring study showed sick sinus syndrome.The patient received dual chamber pacing implantation and was administered drug therapy to control ventricular rate.The patient’s paroxysmal headaches and palpitations had resolved within 1 year,confirmed via a follow-up telephone call.CONCLUSION After dual-chamber pacing implantation and drug therapy administration to control the ventricular rate,the patient’s paroxysmal headaches and palpitations had resolved within 1 year,confirmed via a follow-up telephone call.We believe that the headaches were related to the patient’s sick sinus syndrome.

Sick sinus syndrome associated with hypopituitarism:a case report and literature review

Though an association between autoimmune diseases and sick sinus syndrome has been reported,there has been no report on the association of hypopituitarism and sick sinus syndrome.Herein,we provide the first case report of hypopituitarism accompanying sick sinus syndrome in a 51-year-old woman presented to our hospital with syncope due to cardiac arrest.The patient was successfully managed by pacemaker installation and hormone replacement therapy.

Evaluation of Sick Sinus Syndrome by Holter Monitoring and Follow-up Studies

In 95 patients (55 men and 40 women .aged 20 to 84 years )with sick sinus syndrome (SSS).24-hour monitoring

Hyperthyroidism and severe bradycardia:Report of three cases and review of the literature

BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.

Familial amyloid cardiomyopathy masquerading as chronic Guillain-Barre syndrome： things are not always what they seem

Familial amyloid cardiomyopathy is a challenging condition that mimics many other diseases, particularly in patients with pronounced neurological presentations and unexplained or equivocal cardiac abnormalities. In this case, a 57-year-old man was admitted for outpatient cardiological evaluation of progressive right heart failure and limb paraesthesias. The patient presented with hypertension, chronic Guillain-Barre syndrome, and sick sinus syndrome. Transthoracic echocardiograms showed a thickened ventricular wall and enlarged atrium. Tissue Doppler showed a restrictive filling pattern. Transthyretin （TTR）-associated amyloidosis, which was revealed by abdominal fat-pad biopsy and DNA analysis, explained the concurrence of independent pathological features, including neuropathy and cardiac involvement. Genetic testing identified a G 〉 T mutation in exon 4 of the transthyretin （TTR） gene. This mutation resulted in the alanine-to-serine substitution at amino acid position 117. Moreover, genetic testing confirmed that the patient＇s asymptomatic son carried the same amyloidogenic TTR mutation. Given these findings, the diagnosis of familial amyloid cardiomyopathy, which was misdiagnosed as chronic Guillain-Barre syndrome, was proposed.

Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review

Background:Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients.When involving cavernous sinus and surrounding structures,patients are frequently misdiagnosed with a neoplasm or sellar abscess.Timely diagnosis and intervention are crucial to patients’outcomes.The objective of this study is to review cases of invasive sphenoid sinus aspergillosis to describe disease manifestations,imaging features,treatment,and outcome.Case presentation:We describe four patients with invasive sphenoid sinus aspergillosis misdiagnosed as sellar tumors preoperatively.The mass was completely removed in three patients and partially removed in one patient microscopically.Pathological examinations confirmed Aspergillus in all cases.All four patients received anti-fungal agents postoperatively.There was no recurrence at the time of each patient’s follow-up date.One patient with complete resection was lost to follow-up while the other three patients’neurologic function improved.Additionally,we performed a systematic review regarding invasive sphenoid sinus aspergillosis of existing English literature.Conclusion:With regard to clinical symptoms,headache,vision impairment,and ophthalmoplegia were observed in over half of the patients in the literature.A sellar mass with bone destruction on CT and involvement of cavernous sinus is highly suggestive of invasive fungal sphenoid sinusitis.Immediate surgical removal of the lesion is recommended for invasive sphenoid sinus aspergillosis to preserve nerve function and increase the likelihood of survival.