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Cough Syncope

Timothy C. Hain, MD Page last modified: December 25, 2011
Cough Syncope defined Causes Evaluation Index

Cough syncope is a syndrome in which dizziness or syncope occurs after prolonged bouts of cough. See also the syncope page, if symptoms are not particular associated with a cough.

Cause of cough syncope:

Cough syncope patients not exhibit more pronounced hypotension in response to cough than other fainters, but they also manifest an inappropriate cough-triggered blood pressure-heart rate relationship. These findings argue in favor of the importance of a neurally mediated reflex contribution to symptomatic hypotension in cough syncope. (Benditt, D. G., N. Samniah, et al.; 2005).

It is well known that cough syncope may occur in the Arnold-Chiari malformation (Ireland, P. D., D. Mickelsen, et al. (1996)). This is probably due to impaired autonomic regulation.

 

Evaluation of cough syncope:

Physical examination should include at a minimum

Routine Laboratory Testing:

According to Chao, A. C., R. T. Lin, et al. (2007). Cough syncope patients often exhibit absent BP overshoot following the relief of straining.

According to Choi, Y. S., J. J. Kim, et al. (1989). Sinus arrest may play a role as a mechanism of cough syncope in a patient with sick sinus syndrome, and 24 hour holter monitoring may be helpful in making this diagnosis.

Treatment

Most effort is aimed at treating the cough with cough suppressants, and exhaling before coughing.

If the patient has an central or peripheral dysautonomia, treatment should be directed towards correcting that disorder too.

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Copyright March 24, 2014 , Timothy C. Hain, M.D. All rights reserved. Last saved on March 24, 2014