Severe Cardiac Dysautonomia and Sudden Death in a Patient Presenting with Anginal Symptoms in Absence of Cardiovascular and Other Diseases: A Case Report

Authors

  • Rita Khadka Department of Basic and Clinical Physiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
  • Rajiv Narang Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  • Ashok Kumar Jaryal Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
  • Chetan Patel Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
  • Kishore Kumar Deepak Department of Physiology, All India Institute of Medical Sciences, New Delhi, India

DOI:

https://doi.org/10.31729/jnma.4828

Keywords:

angina; baroreflex; dysautonomia; heart rate; sudden death.

Abstract

Angina is a type of chest pain, experienced by patients with ischemic heart diseases. Cardiac autonomic
modulation as assessed by heart rate variability and baroreflex sensitivity is found reduced in
ischemic heart disease patients. Marked reduction in heart rate variability and baroreflex sensitivity
in ischemic heart disease patients is found associated with sudden cardiac death. We report a case
of a 35-year-old man who presented with angina for the last few months. Thorough investigations
showed no evidence of any cardiac or other systemic diseases. However, his cardiovascular
autonomic modulation (as assessed by heart rate variability) and spontaneous baroreflex sensitivity
were markedly reduced. The patient had sudden death within 6 months of follow-up. Reportedly,
no other specific abnormalities were found before death. This case report suggests that patients
presenting with typical chest pain as angina may have severe dysautonomia and risk of sudden
death even in the absence of cardiovascular or any other known end-organ diseases.

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Published

2020-04-30

How to Cite

Khadka, R., Narang, R., Jaryal, A. K., Patel, C. ., & Deepak, K. K. (2020). Severe Cardiac Dysautonomia and Sudden Death in a Patient Presenting with Anginal Symptoms in Absence of Cardiovascular and Other Diseases: A Case Report. Journal of Nepal Medical Association, 58(224). https://doi.org/10.31729/jnma.4828

Issue

Vol. 58 No. 224 (2020): JNMA: Published Monthly

Section

Case Reports

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