Head Over Heart: An Atypical Presentation of Temporal Lobe Epilepsy.

Ictal asystole is a long-documented medical condition that causes pauses during epileptic episodes. This condition has garnered attention due to resulting accidents. The mechanism of action and treatment guidelines are not well established. We present a case of a 39-year-old male truck driver who presented with dizziness, lightheadedness, confusion, and amnesia with a history of two motor vehicle accidents within one week. During his second hospitalization he underwent pacemaker placement due to presumed sinus node dysfunction. The patient returned with recurrent symptoms and was found to have epileptic focus of the left anterior temporal lobe on electroencephalogram and was thought to have ictal asystole. In this report, we focus on the importance of evaluating for neurogenic cause of cardiac arrythmias.

Non-ST-Segment Myocardial Infarction Resulting From Thrombotic Saphenous Vein Graft Aneurysm.

Acute coronary syndromes from coronary emboli are rare, but well described in the literature. Saphenous vein grafts (SVG), used in coronary artery bypass grafting surgery, are vessels prone to atherosclerotic occlusion and aneurysmal dilation. Descriptive cases of embolization of these atherosclerotic lesions are lacking. Aneurysmal dilation of SVG conduits provides an area of stagnated flow that can harbor thrombi with embolic potential. This case describes a patient with non-ST-segment myocardial infarction possibly resulting from SVG aneurysm thrombus embolism.