Myocarditis — MRCGP AKT MCQ

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HardMedical Conditions in SportMyocarditisMRCGP AKT

A 68-year-old has a transient loss of consciousness immediately after a prolonged coughing bout. There is a clear prodrome, rapid complete recovery, normal examination and no cardiac red flags. What is the most likely mechanism?

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Correct answer: E — Situational reflex syncope

The best answer is “Situational reflex syncope”. Syncope triggered reproducibly by coughing is a situational reflex syncope caused by transient reduction in cerebral perfusion. A careful history, lying and standing blood pressure and ECG remain part of initial assessment, with escalation if red flags emerge. The trigger and rapid recovery make seizure, persistent metabolic disturbance and intracranial bleeding less likely.

Reference: NICE CG109: Transient loss of consciousness: https://www.nice.org.uk/guidance/cg109/chapter/Recommendations