Defecation Syncope Caused by Pulmonary Embolism

Excerpt

To the Editors: Defecation syncope accounts for approximately 5% of all patients who present with syncope (1-4). Pulmonary embolism presenting with syncope is reported in 17% of patients (5). Pulmonary embolism as a cause of defecation syncope has not been well described in the medical literature. We report the cases of four patients with this entity who presented to us over a 12-month period.

A 60-year-old man had a brain tumor surgically removed. On the sixteenth postoperative day after the completion of defecation, he lost consciousness, fell from the commode, and died. Autopsy showed a saddle embolus to be the