{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:51:19Z","timestamp":1792176679090,"version":"4.4.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A high prevalence of nasopharyngeal carcinoma (NPC) has been found in China, but it rarely occurs with syncope. Studies have demonstrated that syncope due to NPC may be related to carotid sinus syndrome, glossopharyngeal irritation, and parapharyngeal and retropharyngeal space lesions. Such patients require evaluation by nasopharyngoscopy and head magnetic resonance imaging\/computed tomography. There is no known single effective treatment for these patients. Various interventions may be considered in an effort to relieve syncope, including vasoconstrictive drugs, cardiac pacemaker implantation, radiotherapy and chemotherapy, and surgical resection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>This case report describes a 56-year-old man who developed recurrent syncope with atrial fibrillation, a long RR interval, and hypotension. A single chamber pacemaker was fitted, but it failed to relieve the symptom. Cranial magnetic resonance imaging and pathological tests led to a final diagnosis of NPC. After six courses of chemotherapy and 35 sessions of radiotherapy, the patient became asymptomatic. However, he died from a massive uncontrolled hemorrhage in the nasopharynx two years later.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This case brings attention to the fact that syncope can be a symptom of NPC. Due to the insidiously malignant nature of this cancer, when a patient presents with syncope, clinicians should bear in mind this connection, albeit a rare one. There are at least two ways of treating NPC-associated syncope, but there is disagreement about which is the most effective.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-023-03174-2","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T08:03:18Z","timestamp":1678780998000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Syncope as the initial symptom in a patient with nasopharyngeal carcinoma: a case report"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1320-6000","authenticated-orcid":false,"given":"Lin-lin","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-kun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"3174_CR1","first-page":"211","volume":"28","author":"WG Hou","year":"2022","unstructured":"Hou WG, Ma Z, Zhao WJ. Two cases of head and neck malignancies with syncope as the first symptom. J Tianjin Med Univ. 2022;28:211\u20133.","journal-title":"J Tianjin Med Univ"},{"key":"3174_CR2","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1097\/CRD.0000000000000041","volume":"23","author":"V Amin","year":"2015","unstructured":"Amin V, Pavri BB. Carotid sinus syndrome. Cardiol Rev. 2015;23:130\u20134.","journal-title":"Cardiol Rev"},{"key":"3174_CR3","doi-asserted-by":"publisher","first-page":"e12335","DOI":"10.1097\/MD.0000000000012335","volume":"97","author":"S Zhang","year":"2018","unstructured":"Zhang S, Wei C, Zhang M, Su M, He S, He Y. Syncope and hypotension associated with carotid sinus hypersensitivity in a patient with nasopharyngeal carcinoma: A case report. Medicine (Baltimore). 2018;97:e12335.","journal-title":"Medicine (Baltimore)"},{"key":"3174_CR4","first-page":"134","volume":"34","author":"H Wang","year":"2013","unstructured":"Wang H, Wang YL, Li J. Syncope and NPC. Cardiovasc Dis Prog. 2013;34:134\u20137.","journal-title":"Cardiovasc Dis Prog"},{"key":"3174_CR5","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/S0300-8932(01)76369-5","volume":"54","author":"A C\u00f3rdoba L\u00f3pez","year":"2001","unstructured":"C\u00f3rdoba L\u00f3pez A, TorricoRom\u00e1n P, Inmaculada Bueno Alvarez-Arenas M, MonterrubioVillar J, Corcho S\u00e1nchez G. Syncope due to parapharyngeal space lesions syncope-syndrome. Rev Esp Cardiol. 2001;54:649\u201351.","journal-title":"Rev Esp Cardiol."},{"key":"3174_CR6","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","volume":"39","author":"M Brignole","year":"2018","unstructured":"Brignole M, Moya A, de Lange FJ, et al. ESC Scientific Document Group. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39:1883\u2013948.","journal-title":"Eur Heart J."},{"key":"3174_CR7","doi-asserted-by":"publisher","first-page":"612","DOI":"10.33963\/KP.15454","volume":"78","author":"P Ku\u0142akowski","year":"2020","unstructured":"Ku\u0142akowski P, Baran J. Parasympathetic denervation as an alternative to permanent pacing. Kardiol Pol. 2020;78:612\u20133.","journal-title":"Kardiol Pol"},{"key":"3174_CR8","first-page":"199","volume":"36","author":"B Zhang","year":"2022","unstructured":"Zhang B, Li L, Jiang RH. Observation of cardiac ganglion plexus ablation in the treatment of cardiac inhibitory carotid sinus syndrome. Chin J Heart Pacing Heart Electrophysiol. 2022;36:199\u2013203.","journal-title":"Chin J Heart Pacing Heart Electrophysiol"},{"key":"3174_CR9","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1097\/NRL.0b013e31825cf197","volume":"18","author":"E Degirmenci","year":"2012","unstructured":"Degirmenci E, Erdogan C, Aras D, O\u011fuzhano\u011flu A. Nasopharyngeal carcinoma presenting with horner syndrome and carotid-sinus syncope. Neurologist. 2012;18:208\u201310.","journal-title":"Neurologist"},{"key":"3174_CR10","doi-asserted-by":"publisher","first-page":"725","DOI":"10.3349\/ymj.2009.50.5.725","volume":"50","author":"JH Ju","year":"2009","unstructured":"Ju JH, Kang MH, Kim HG, et al. Successful treatment of syncope with chemotherapy irresponsive to cardiac pacemaker in head and neck cancer. Yonsei Med J. 2009;50:725\u20138.","journal-title":"Yonsei Med J"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-023-03174-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-023-03174-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-023-03174-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T08:03:46Z","timestamp":1678781026000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-023-03174-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,14]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["3174"],"URL":"https:\/\/doi.org\/10.1186\/s12872-023-03174-2","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,14]]},"assertion":[{"value":"14 October 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the ethics committee of Huantai County People\u2019s Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from individual participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of their clinical details and\/or clinical images was obtained from the patient on August 16,2021. A copy of the consent form is available for review by the Editor of this journal. Written informed consent was obtained from individual participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"134"}}