Letter to the Editor| Volume 39, ISSUE 5, P656-658, November 2010

A Rare Cause of Junctional Rhythm Causing Syncope; Mad Honey Intoxication

      A 50-year-old man was admitted to our Emergency Department (ED) with complaints of blurred vision, dizziness, and a syncopal event 30 min prior without chest pain, palpitation, or dyspnea. He did not have any cardiovascular or systemic illnesses and was not taking any medication or herbal products. In his past medical history, he described a syncopal attack 6 months before that occurred after a meal and his cardiovascular evaluation was reported normal at that time. The patient had eaten a breakfast that included two bowls of honey 3 h before arrival. Physical examination revealed a pulse rate of 44 beats/min and a blood pressure of 80/55 mm Hg. An electrocardiogram (ECG) showed junctional rhythm with a ventricular rate of 44 beats/min (Figure 1). Blood chemistry and complete blood count were within normal limits.
      Figure thumbnail gr1
      Figure 1Electrocardiography showing junctional rhythm on admission.
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