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I read with interest the article by Vloka et al¹ that was recently published in the ARCHIVES. I would like to add to their interesting correlations between neurocardiogenic syndrome and other conditions; we recently reported² the same syndrome accompanied by Prinzmetal angina and bronchogenic carcinoma. At the time of that report, we saw a patient with severe, recent-onset, crescendo, life-threatening manifestations of neurogenic imbalance that were totally and immediately relieved by administration of a chemotherapeutic agent. At 2-year follow-up, this patient is clinically free of disease (carcinoma) and totally asymptomatic for syncope, angina, and arrhythmias and is not receiving any medication.

We postulated that this patient's carcinoma was able to produce the cardiovascular manifestations by means of paraneoplastic activity and concluded that a history of newly developed neurocardiogenic syndrome in an older patient should alert the cardiologist to the possibility of a paraneoplastic syndrome.

I believe that the first patient . . . [Full Text of this Article]

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