A 62-year-old woman known with a depressive disorder but unremarkable cardiovascular history was admitted to our emergency department in a state of unconsciousness. Her husband had found her unconscious at home and called an ambulance. She had no history of syncope or suicidality. Physical examination demonstrated a Glasgow Coma Scale of E1M5V1 without any lateralising neurological symptoms. She was haemodynamically stable, but was intubated because of failure to maintain airway tone due to unconsciousness. She had no fever. Laboratory results showed: sodium 150 mmol/l, potassium 3.2 mmol/l, a normal glomerular filtration rate, haemoglobin 7.6 mmol/l; normal thrombocytes and leucocytes. The ECG on admission is shown in Fig. 1.