Hyperventilation-Apnoea Syndrome in a 79-year Old Woman with Congestive Heart Failure |Biomedgrid

We report the case of a 79-year woman admitted for daily episodes of sudden breath arrest abruptly occurred one month prior to hospital presentation. These episodes are preceded by hyperventilation due to physical activity, especially when working in bending forward position. She was diagnosed and treated for high blood pressure, coronary heart disease, major left bundle branch block, congestive heart failure, obesity, hypercholesterolaemia and hypothyroidism. Spirometry was normal, chest x-ray showed features of basal bilateral pulmonary fibrosis, overnight respiratory polygraphy revealed moderate obstructive sleep apnoea, while cerebral magnetic resonance imaging showed a right ventrolateral compression of the medulla oblongata – spinal cord junction by a dominant, sinuous right vertebral artery, and loss of foramen magnum cerebrospinal fluid due to low lying cerebellar tonsils tips, while cisterna magna is still visible. The rare breathing pattern of our patient is reported in the literature as hyperventilation-apnoea syndrome and we discuss the potential mechanisms underlying this condition.