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  Česky / Czech version Prakt. Lék., 2007, 87, No. 4, pp. 241-242
 
Epileptic fit as a syncope equivalent in severe aortic stenosis 
KRÚGER A., NIEDERLE P. 

Kardiologické oddělení Nemocnice Na Homolce, Praha Přednosta: prof. MUDr. Petr Niederle, DrSc.
 


Summary:

       The case report of a patient suffering from dyspnea and chest pain together with a history of repetitive epileptic paroxysms within the past few months is presented. The epileptic fits were also registered during his hospital stay. Transthoracic echocardiography proved moderate left ventricular dysfunction (ejection fracti-on 33 %) and severe aortic valve stenosis (peak pressure gradient 102 mmHg, aortic valve area 0.45 cm2). The epileptic fits were also documented by electroencephalography (EEG) and a transcranial Doppler stu¬dy detected reduced blood flow within the intracerebral arteries. The patient underwent successful cardio-surgery to replace the stenotic aortic valve with a mechanical prothesis (SJM Regent 25 mm). Myocardial function showed marked improvement (EF 50 %) following the proceduře. Repeated EEG examination exhibited completely normál findings. At present, the patient remains in good health without any epileptic fits. We consider the čase of aortic stenosis inducing epileptic symptoms caused by transient cerebral ische-mia extremely rare and informative for generál practitioners and other physicians.

        Key words: severe aortic stenosis, secondary epilepsy.
       

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