Not CFS: "Psychogenic Syncope? A Cautionary Note"

[Esther12]

Psychogenic Syncope? A Cautionary Note

http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8159.2009.02400.x/abstract

Introduction: In some patients with recurrent syncope, the etiology may remain unclear despite extensive evaluation. These patients may sometimes be labeled as having a psychogenic cause for their syncope.

Methods: We report on three patients with recurrent unexplained syncope (despite extensive evaluation) who were labeled as having a psychogenic cause for their events. In each patient following placement of an implantable loop recorder, their syncopal events were found to be due to periods of prolonged asystole and/or complete heart block. One patient had prolonged asystole for 44 seconds. In each patient, episodes of syncope were eliminated following permanent pacemaker implantation.

Conclusion: We conclude that physicians should exercise great caution before labeling any patient's syncope as psychogenic and that prolonged monitoring may be necessary to exclude a potential cardiac rhythm-related etiology.





The first and last authors also did an article on POTS in post-Lyme patients that has already been posted: http://www.cardiologyjournal.org/inpress/122010Kanjwal.pdf

I'm not sure how respectable they are, but my PC's breaking as I started opening pdf files to look in to it, so thought I'd just post the details up.

 

[Angela Kennedy]

Psychogenic Syncope? A Cautionary Note

http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8159.2009.02400.x/abstract

Introduction: In some patients with recurrent syncope, the etiology may remain unclear despite extensive evaluation. These patients may sometimes be labeled as having a psychogenic cause for their syncope.

Methods: We report on three patients with recurrent unexplained syncope (despite extensive evaluation) who were labeled as having a psychogenic cause for their events. In each patient following placement of an implantable loop recorder, their syncopal events were found to be due to periods of prolonged asystole and/or complete heart block. One patient had prolonged asystole for 44 seconds. In each patient, episodes of syncope were eliminated following permanent pacemaker implantation.

Conclusion: We conclude that physicians should exercise great caution before labeling any patient's syncope as psychogenic and that prolonged monitoring may be necessary to exclude a potential cardiac rhythm-related etiology.





The first and last authors also did an article on POTS in post-Lyme patients that has already been posted: http://www.cardiologyjournal.org/inpress/122010Kanjwal.pdf

I'm not sure how respectable they are, but my PC's breaking as I started opening pdf files to look in to it, so thought I'd just post the details up.

Thanks for this Esther. Psychogenic syncope eh? Wow.

Next up -psychogenic death - couldn't find the cause of death- presumed psychogenic...

 

[oceanblue]

Not CFS indeed! Thanks, Esther12.

 

[anciendaze]

I guess I didn't pay enough. I only got a diagnosis of "unexplained loss of consciousness". The EMT crew reported a possible seizure.

 

[Lynn]

Next up -psychogenic death - couldn't find the cause of death- presumed psychogenic...

Thanks Angela. My husband and I have been laughing about this all weekend. It really puts things in perspective. We can't find the cause so maybe we xhould label it due to "false death beliefs".

Lynn

 

[Angela Kennedy]

Thanks Angela. My husband and I have been laughing about this all weekend. It really puts things in perspective. We can't find the cause so maybe we xhould label it due to "false death beliefs".

Lynn

Glad that made you both laugh Lynn

'false death beliefs' got me laughing now in return!

 

[WillowJ]

that's great, thanks for posting and for the jokes

 

[Angela Kennedy]

Actually we laugh - but when his sister, Alice James, died of breast cancer at the age of 42, after having been labelled a hysteric and a neurasthenic all her life because of illness of unknown ateiology, the psychologist and (I believe MD) William James (brother of author Henry) wrote in a letter to Henry that he couldn't be sure she was dead and not in some neurasthenic trance (I'm paraphrasing slightly).

This seems to have been in a context of the literary gothic obsession at the time with psychogenic catatonic trances leading to people being buried alive - as typified by Edgar Allen Poe's "Fall of the House of Usher". I've never seen an actual reported case of such a thing- but it's a recurring theme in Victorian gothic literature.

There is something of the gothic and literary ad hoc (not to mention Freudian ad hoc) in many contemporary psychogenic explanations. Maybe it IS something we have to look forward to: psychogenic explanations for death in the absence of a clear cause...