Case History/examination
A 73-year-old male with previous diagnoses of hypertension and prostate
cancer was diagnosed three months ago, and the patient’s treatment
started eight weeks ago; he was taken to the emergency department
because of an ongoing complaint of dizziness episodes and snoring with
convulsive movement, notably as sleeping, since two weeks ago. He
experienced two syncope episodes in the last week but did not have any
prodromes such as palpitations, blurred vision, lightheadedness, feeling
hot, nausea, or sweating. His companions mentioned that he did not
develop urinary incontinence, tongue biting, or paleness after the
syncope episodes. Syncope episodes occurred while sitting, lasting 10 to
20 minutes, and the patient snored. He had not had a coronary evaluation
and did not indicate any family history of heart disease and SCD.
The vital signs were a body temperature of 37.5℃, BP of 130/85 mm Hg,
pulse rate of 70 beats/min, respiratory rate of 12 breaths/min, and
oxygen saturation of 96% without supplemental oxygen during the initial
examination. Auscultation of the heart in the emergency room showed a
regular heartbeat. Electrocardiogram (ECG): sinus rhythm and QTc
interval 625 ms (Fig. 1). We noticed a prolonged QT interval in his
ECG. (Calculated with Bazett’s formula)