When Fainting Wasn’t a Heart Problem: Lalita’s Journey to Recovery | Manipal Hospital Dhakuria

Lalita initially presented with recurrent episodes of losing consciousness, accompanied by persistent headaches and blurred vision, leading medical professionals to immediately suspect a cardiac cause for her syncope. Extensive evaluations including coronary angiograms, recurrent Holter monitoring, and carotid angiograms all returned normal results, effectively ruling out heart-related issues. Despite these clear findings, Lalita remained frustrated and confused about the source of her symptoms, prompting the medical team to investigate potential neurological abnormalities given her ongoing headaches that persisted for months after the initial episodes. Further investigation revealed an empty sella on her MRI brain scan, indicating the absence of the pituitary gland at that time, but this finding alone could not explain the severity of her condition. With the guidance of neuromedicine specialist Dr. Kaushik Dutta, the team decided to proceed with an MR venogram because the persistent headache suggested a deeper vascular issue beyond the missing pituitary gland. The scan uncovered a significant tight stenosis in the right transverse sinus of her brain, revealing that the veins within her skull were severely narrowed, which was raising dangerous pressure levels inside her head. The diagnosis was confirmed through additional studies showing high opening pressure in the cerebrospinal fluid and papilledema observed by ophthalmologists, indicating that her vision was indeed compromised due to the increased intracranial pressure. Recognizing that this venous stenosis was the primary cause of her recurrent loss of consciousness rather than a heart problem, the medical team made the urgent decision to surgically open up the affected vein. This intervention required the support of the entire cath lab team and involved Dr. Sukulan Purokayastha and his colleagues to perform a groundbreaking procedure. The culmination of this complex journey was the successful stenting of the brain vein, marking the first time such an angioplasty had ever been performed on a vessel within the brain specifically for a case involving loss of consciousness without cardiac symptoms. This innovative approach not only addressed the root cause of Lalita's debilitating episodes but also highlighted the importance of looking beyond standard cardiac evaluations when syncope is accompanied by neurological signs like headaches and vision changes. The successful operation provided a definitive solution to her condition, demonstrating how multidisciplinary collaboration can lead to life-changing outcomes for patients with rare and complex medical histories.