Fear of truth is fear of ignorance: a case report

    Authors

    Keywords

    cardiogenic syncope, holter ECG, electrostimulator, patient education

    DOI

    https://doi.org/10.15836/ccar2024.626

    Full Text

    **Introduction**: Holter ECG is a method of detecting bradycardia and tachycardia heart rhythm disorders. (1) This paper will present the case of a patient with intermittent AV block who is a professional driver. **Case report**: N.N., male, aged 60, who hid his ailments until he was persuaded to submit to diagnostic treatment, which established the seriousness of the case itself and indicated the urgent implantation of an electrostimulator. Through the conversation after the first diagnostic test, we found out that the patient had been suffering for a long time, but he attributed his problems in the form of dizziness, general weakness, and on a couple of occasions loss of consciousness to having a “bad day”, lack of fluid intake, and simply took it as a passing phase he has to keep to himself since he is a professional driver. The ailments he had did not cause him as much of a concern, as he was more concerned about keeping his driver’s license. Upon persuasion, a holter ECG was performed, which determined AV block Mobitz II (2:1) in the awake state with a low frequency. The patient was referred to the Emergency Department, and admission to the department was arranged due to the indication for the implantation of an electrostimulator. **Conclusion**: Cardiogenic syncope can lead to serious consequences, especially if it happens in specific, professional job, as in this case. Professional driving requires complete concentration on oneself and one’s surroundings. It is important to emphasize that educating and informing the patient himself is crucial when establishing a diagnosis so that similar things are not covered up and thus endanger their own health and that of others.

    Literature

    1. Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021 September 14;42(35):3427–520. https://doi.org/10.1093/eurheartj/ehab364
    Cardiologia Croatica
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    Fear of truth is fear of ignorance: a case report

    Extended Abstract
    Issue11-12
    Published
    Pages626
    PDF via DOIhttps://doi.org/10.15836/ccar2024.626
    cardiogenic syncope
    holter ECG
    electrostimulator
    patient education

    Authors

    Tomislav Glavak*ORCIDUniversity Hospital Centre “Sestre milosrdnice” Zagreb, Croatia
    Valentina SedinićORCIDUniversity Hospital Centre “Sestre milosrdnice” Zagreb, Croatia
    Nives BognarORCIDUniversity Hospital Centre “Sestre milosrdnice” Zagreb, Croatia

    *Correspondence email: tglavak@gmail.com

    Full Text

    Introduction: Holter ECG is a method of detecting bradycardia and tachycardia heart rhythm disorders. (1) This paper will present the case of a patient with intermittent AV block who is a professional driver.

    Case report: N.N., male, aged 60, who hid his ailments until he was persuaded to submit to diagnostic treatment, which established the seriousness of the case itself and indicated the urgent implantation of an electrostimulator. Through the conversation after the first diagnostic test, we found out that the patient had been suffering for a long time, but he attributed his problems in the form of dizziness, general weakness, and on a couple of occasions loss of consciousness to having a “bad day”, lack of fluid intake, and simply took it as a passing phase he has to keep to himself since he is a professional driver. The ailments he had did not cause him as much of a concern, as he was more concerned about keeping his driver’s license. Upon persuasion, a holter ECG was performed, which determined AV block Mobitz II (2:1) in the awake state with a low frequency. The patient was referred to the Emergency Department, and admission to the department was arranged due to the indication for the implantation of an electrostimulator.

    Conclusion: Cardiogenic syncope can lead to serious consequences, especially if it happens in specific, professional job, as in this case. Professional driving requires complete concentration on oneself and one’s surroundings. It is important to emphasize that educating and informing the patient himself is crucial when establishing a diagnosis so that similar things are not covered up and thus endanger their own health and that of others.

    Literature

    1. 1.
      Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021 September 14;42(35):3427–520.DOI