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Chest, Vol 68, 250-253, Copyright © 1975 by American College of Chest Physicians

ARTICLES

Idiopathic hypertrophic subaortic stenosis presenting as cough syncope

CW White, TJ Zimmerman and M Ahmad

In a patient with idiopathic hypertrophic subaortic stenosis, syncope developed as a result of a sustained decrease in aortic pressure induced by severe cough paroxysms. Treatment with propranolol was effective in abolishing the syncopal episodes, by reducing the post- tussive gradient and facilitating a more rapid return to normal of aortic pressure. Post-tussive syncope in IHSS may result from both an unusually strong cough paroxysm and augmented left ventricular outflow obstruction consequent to reflex sympathetic stimulation.


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R. S. Irwin
Complications of Cough: ACCP Evidence-Based Clinical Practice Guidelines
Chest, January 1, 2006; 129(1_suppl): 54S - 58S.
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Copyright © 1975 by the American College of Chest Physicians.