Visual Prodrome and Syncope as Atypical Manifestations of Severe Triple-Vessel Coronary Artery Disease Leading to Motor Vehicle Collision: A Case Report

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ID: 323334
2026
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Abstract
Abstract Background Adverse coronary events usually present with angina, yet non-classical symptoms in the absence of angina may pose as a delay in recognizing severe disease. Case Summary A 65-year-old man presented after a motor vehicle collision preceded by transient illuminated halos in bilateral visual fields. Inpatient evaluation demonstrated anterolateral ST-segment depressions on electrocardiogram, mildly elevated high-sensitivity troponins. Coronary angiography revealed severe triple-vessel coronary artery disease (CAD), prompting a referral to cardiothoracic surgery for quadruple coronary artery bypass grafting. Contributing comorbidities included untreated hypothyroidism, dyslipidemia, prediabetes, obesity and hypertension. Discussion This case highlights the importance of recognizing atypical prodromes in patients with silent myocardial ischemia contributing to CAD, particularly when multiple known cardiovascular risk factors are present. Silent ischemia may manifest with syncope or visual symptoms. Early recognition, prevention and treatment of comorbidities through comprehensive cardiovascular risk assessment may help prevent advanced coronary disease and improve outcomes. Even in the absence of chest pain, clinicians should maintain a low threshold for completing cardiovascular risk assessment in high-risk patients presenting with syncope or transient visual symptoms.
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openalex_W7172308019 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Syed Moaiz Adnan, Syed Moaiz Adnan, Rama Garimella
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag568
URL
https://doi.org/10.1093/ehjcr/ytag568
Keywords Keywords not found

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