An 84-year-old white woman presented with a 3-month history of
frequent near-syncope episodes and a new systolic murmur. The
syncope episodes were unrelated to physical exercise, change in body or
head position, cough, micturition, swallowing, or cardiac symptoms.
Nine years prior to admission, the patient had received a diagnosis of
melanoma of the choroid of the left eye, and she was treated with
radium implants. Five years later, the patient began to complain of
frequent episodes of transient disequilibrium. An extensive evaluation
including ECG, echocardiogram, Holter studies, chest radiograph, brain
MRI, electroencephalogram, and carotid ultrasound was unrevealing.