مورد إلكتروني
The role of tilt-table test in differential diagnosis of unexplained syncope
| العنوان: | The role of tilt-table test in differential diagnosis of unexplained syncope |
|---|---|
| عناروين إضافية: | Uloga tilt testa u diferencijalnoj dijagnostici neobjašnjene sinkope |
| المصدر: | Acta clinica Croatica; ISSN 0353-9466 (Print); ISSN 1333-9451 (Online); Volume 54.; Issue 4. |
| بيانات النشر: | Sestre Milosrdnice University hospital and Institute of Clinical Medical Research 2015 |
| تفاصيل مُضافة: | Marko Mornar Jelavić Zdravko Babić Hrvoje Hećimović Vesna Erceg Hrvoje Pintarić |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | The aim of this retrospective study (February 2012 – September 2014) was to assess the role of head-up tilt-table test in patients with unexplained syncope. It was performed on 235 patients at Clinical Department of Cardiology, Sestre milosrdnice University Hospital Center. Patients were classified according to test indications: group A (convulsive syncope, n=30), group B (suspected vasovagal syncope, n=180), and group C (paroxysmal vertigo, n=25). The groups were analyzed and compared according to demographic data (age and gender), referral specialist (cardiologist, neurologist, and others), and test results (positive/negative) with specific response (cardioinhibitory, vasodepressor, or mixed). Groups A and B were referred most frequently by neurologists and cardiologists (p<0.05). The test was positive in 34 (14.5%) of all evaluated patients (5 in group A and 29 in group B), of which 13 (38.2%) had cardioinhibitory, 11 (32.4%) mixed and 10 (29.4%) vasodepressor response. In the cardioinhibitory subgroup, three patients (23.1%, 2 males/1 female, mean age 28.5 years) with normal electroencephalography were on antiepileptics. During headup tilt-table testing, they had bradycardia (heart rate 30.0±5.0 beats/min) and prolonged asystole (13.7±11.0 seconds) with development of typical convulsions. These three subjects got a permanent pacemaker (atrial/ventricular stimulation, heart rate control) and anticonvulsive therapy was slowly withdrawn with no syncope recurrence during 24-month follow up. In conclusion, head-up tilt-table test has an important role in the evaluation of patients with unexplained syncope and in differential diagnosis of vasovagal syncope. The indication for pacemaker implantation, strictly following the European Society of Cardiology guidelines, proved to be effective in preventing syncope relapses in patients with cardioinhibitory convulsive syncope. Cilj ovoga retrospektivnog istraživanja (veljača 2012. – rujan 2014. godine) bio je ispitati ulogu tilt testa u bolesnika s neobjašnjenom sinkopom. Provedeno je na 235 bolesnika u Zavodu za kardiologiju KBC-a “Sestre milosrdnice”. Bolesnici su klasificirani prema indikaciji za izvođenje testa: skupina A (konvulzivna sinkopa, n=30), skupina B (suspektna vazovagalna sinkopa, n=180) i skupina C (paroksizmalni vertigo, n=25). Skupine su analizirane i uspoređivane prema njihovim demografskim podacima (dob, spol), specijalistima koji su ih uputili na pretragu (kardiolozi, neurolozi, ostali) te rezultatima (pozitivan/negativan) i specifičnim odgovorima (kardionhibicija, vazodepresija ili mješoviti) tilt testa. Skupine A i B najčešće je na testiranje uputio neurolog i kardiolog (p<0,05). Test je bio pozitivan u 34 (14,5%) bolesnika (5 u skupini A i 29 u skupini B), od kojih je 13 (38,2%) imalo kardioinhibicijski, 11 (32,4%) mješoviti i 10 (29,4%) vazodepresivni odgovor. U kardioinhibicijskoj podskupini troje bolesnika (23,1%, 2 muškarca/1 žena, srednje dobi 28,5 godina) je imalo normalan nalaz elektroencefalografije i uzimali su antiepileptike. Tijekom izvođenja testa zabilježili smo bradikardiju (30,0±5,0 otkucaja/min) i produženu asistoliju (13,7±11,0 sekunda) uz pojavu tipičnih konvulzija. U sve troje bolesnika ugrađen je trajni elektrostimulator (atrijska/ventrikulska stimulacija, kontrola frekvencije) i ukinuta je antikonvulzivna terapija, nakon čega su tijekom 24 mjeseca praćenja bili bez recidiva sinkope. U zaključku, tilt test ima važnu ulogu u procjeni bolesnika s neobjašnjenom sinkopom i u diferencijalnoj dijagnostici vazovagalne sinkope. Indikacija za ugradnju elektrostimulatora, strogo slijedeći smjernice Europskoga kardiološkog društva, pokazala se učinkovitom u sprječavanju recidiva sinkopa u bolesnika s kardioinhbicijskom konvulzivnom sinkopom. |
| مصطلحات الفهرس: | Syncope – diagnosis; Syncope – prevention and control; Syncope, vasovagal – diagnosis; Tilt-table test; Pacemaker, artificial; Epilepsy, Sinkopa – dijagnostika; Sinkopa – prevencija i kontrola; Sinkopa, vazovagalna – dijagnostika; Test tilt-table; Srčani elektrostimulator; Epilepsija, text, info:eu-repo/semantics/article, info:eu-repo/semantics/publishedVersion |
| URL: | |
| الإتاحة: | Open access content. Open access content info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-nd/4.0 |
| ملاحظة: | application/pdf English |
| أرقام أخرى: | HRCAK oai:hrcak.srce.hr:154831 985417135 |
| المصدر المساهم: | HRCAK PORTAL ZNANSTVENIH CASOPISA REPUB From OAIster®, provided by the OCLC Cooperative. |
| رقم الأكسشن: | edsoai.ocn985417135 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |