Diagnosing neurocardiogenic syncope [Diagnostik der neurokardiogenen synkope]

被引：0
作者：
Hoffmann N. [1 ]
Steffen H.-M. [1 ]
机构：
[1] Klinik IV für Innere Medizin, Klinikum der Universität Köln
来源：
Herzschrittmachertherapie und Elektrophysiologie | 2002年 / 13卷 / 2期
关键词：
Diagnostic evaluation; Neurocardiogenic syncope; Tilt-table testing;
D O I：
10.1007/s00399-002-0341-x
中图分类号：
学科分类号：
摘要：
Neurocardiogenic syncope results from reflex-mediated changes in autonomic vascular tone and/or heart rate. These reflexes give rise to a transient vasodilation and bradycardia with spontaneous recovery and literally no associated mortality. Neurocardiogenic syncopes, i.e. vasovagal attacks, situational syncope, e.g. micturition syncope, glossopharyngeal and trigeminal neuralgia, and carotid sinus syncope comprise the largest group of disorders causing sudden loss of consciousness. The sometimes impressive clinical picture can lead to expensive investigations which may be prevented by following rational algorithms in the evaluation of syncope. In most cases a careful history-taking may be diagnostic or guide the strategy of evaluation. Tilt testing, which has to follow specified protocols including pharmacological provocation, can be considered diagnostic when spontaneous syncope is reproduced.
引用
收藏
页码：72 / 78
页数：6
相关论文
共 32 条
  • [1] Abboud F.M., Neurocardiogenic syncope, N Engl J Med, 328, pp. 1117-1120, (1993)
  • [2] Alboni P., Brignole M., Menozzi C., Raviele A., Del Rosso A., Dinelli M., Solano A., Bottoni N., Diagnostic value of history in patients with or without heart disease, J Am Coll Cardiol, 37, pp. 1921-1928, (2001)
  • [3] Ammirati F., Colivicchi F., Biffi A., Magris B., Pandozi C., Santini M., Head-up tilt testing potentiated with low-dose sublingual isosorbide dinitrate: A simplified time-saving approach for the evaluation of unexplained syncope, Am Heart J, 135, pp. 671-676, (1998)
  • [4] Bartoletti A., Gagioli G., Menozzi C., Bottoni N., Del Rosso A., Mureddu R., Musso G., Foglia-Manzillo G., Bonfigli B., Brignole M., Head-up tilt testing potentiated with oral nitroglycerin: A randomized trial of the contribution of a drug-free phase and a nitroglycerin phase in the diagnosis of neurally mediated syncope, Europace, 1, pp. 182-186, (1999)
  • [5] Bartoletti A., Alboni P., Ammirati F., Brignole M., Del Rosso A., Foglia Manzillo G., Menozzi C., Raviele A., Sutton R., The Italian Protocol": A simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope, Europace, 2, pp. 339-342, (2000)
  • [6] Benditt D.G., Remole S., Bailin S., Dunnigan A., Asso A., Milstein S., Tilt table testing for evaluation of neurally-mediated (cardioneurogenic) syncope: Rationale and proposed protocols, Pacing Clin Electrophysiol, 14, pp. 1528-1537, (1991)
  • [7] Brignole M., Menozzi C., Del Rosso, Costa S., Gaggioli G., Bottoni N., Bartoli P., Sutton R., New classification of vasovagal syncope: Beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Vasovagal Syncope International Study, Europace, 2, pp. 66-76, (2000)
  • [8] Brignole M., Alboni P., Benditt D., Bergfeldt L., Blanc J.J., Bloch Thomsen P.E., Van Dijk J.G., Fitzpatrick A., Hohnloser S., Janousek J., Kapoor W., Kenny R.A., Kulakowski P., Moya A., Raviele A., Sutton R., Theodorakis G., Wieling W., Guidelines on management (diagnosis and treatment) of syncope, Eur Heart J, 22, pp. 1256-1306, (2001)
  • [9] Del Rosso A., Bartoli P., Bartoletti A., Brandinelli-Geri A., Bonechi F., Maioli M., Mazza F., Michelucci A., Russo L., Salvetti E., Sansoni M., Zipoli A., Fierro A., Ieri A., Shortened head-up tilt testing potentiated with sublingual nitroglycerin in patients with unexplained syncope, Am Heart J, 135, pp. 564-570, (1998)
  • [10] Dietz N.M., Joyner M.J., Shepherd J.T., Vasovagal syncope and skeletal muscle vasodilatation: The continuing conundrum, PACE, 20, pp. 775-780, (1997)
1234