Effectiveness of beta-blockers with neurocardiogenic syncope

Aim: Syncope is a condition characterized by sudden and temporary loss of consciousness, accompanied by a loss of postural tone. In its pathophysiology, there can be a sudden drop in cerebral blood flow, alterations in the composition of the blood reaching the brain, or psychological causes. The aim of this study is to search the etiologies of syncope in children and evaluate the effectiveness of beta-blocker treatment in cases with neurocardiogenic syncope. Material and Methods: The study included 51 patients admitted to our hospital with syncope complaints over a period of 18 months. Patients were evaluated by history, physical examination, laboratory tests, Electrocardiography (ECG), 24-hour holter monitoring, tilt test and EEG. Patients with a positive tilt test were divided into two subgroups. One group was given beta-blocker treatment, and the other group was given only recommendations. Results: The tilt test was positive in 23 (45,09%) of 51 patients presenting with syncope complaints. Metoprolol was administered to 11(21,56%) of the patients. Metoprolol was used as a beta-blocker for 6 months. Conservative treatment was administered to 12 (23.52%) of them. The group not given beta-blockers was advised to take enough water and salt, not to stand for long periods of time, raise the head of the bed by 20 degrees, and not to get up suddenly from the bed or from where they were sitting. When the syncope recurrence was questioned at the end of the 1-year follow-up after treatment or offers, no recurrence of syncope was observed in patients who received or did not receive treatment. Discussion: The tilt test is the only noninvasive test used in the definitive diagnosis of neurocardiogenic syncope and should be performed in doubtful cases to clarify the diagnosis. In the treatment and follow-up of patients with vasovagal syncope, it should be taken into consideration that some precautions before drug therapy may be sufficient. These suggestions are not to stand for a long time, to ensure adequate water intake, not fasting, to raise the head of the bed 20 degrees, and not to get up suddenly from the bed or sitting position. There are no difference between the two groups in terms of recurrence of syncope. beta-blocker treatment has no effect on the recurrence of neurocardiogenic syncope.