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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 1Electrocardiography showing junctional rhythm on admission.
