Postural syncope: Mechanisms and management

Medical Journal of Australia

Volumn 187, Issue 5, 2007, Pages 299-304

  Vaddadi, Gautam ^a   Lambert, Elisabeth ^a   Corcoran, Susan J ^b   Esler, Murray D ^a  

^a BAKER IDI HEART AND DIABETES INSTITUTE   (Australia)

^b ST VINCENT S HOSPITAL   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CHOLINESTERASE INHIBITOR; DIHYDROERGOTAMINE; ERYTHROPOIETIN; FLUDROCORTISONE; HYDRALAZINE; METHYLPHENIDATE; METOPROLOL; MIDODRINE; NATURAL PRODUCT; PLACEBO; REBOXETINE; SEROTONIN NORADRENALIN REUPTAKE INHIBITOR; SEROTONIN UPTAKE INHIBITOR; VENLAFAXINE;

ARTICLE; AUTONOMIC DYSFUNCTION; BEDTIME DOSAGE; BLOOD ANALYSIS; BLOOD PRESSURE MEASUREMENT; BODY POSTURE; BRADYCARDIA; BRAIN BLOOD FLOW; BRAIN VASOSPASM; CARDIOVASCULAR DISEASE; CHRONIC DISEASE; CLINICAL EXAMINATION; CLINICAL TRIAL; DAILY LIFE ACTIVITY; DIAGNOSTIC TEST; DIASTOLIC BLOOD PRESSURE; DISEASE CLASSIFICATION; DISEASE COURSE; ELECTROCARDIOGRAPHY; EMERGENCY CARE; FLUID THERAPY; GEOGRAPHIC DISTRIBUTION; HEAD TILTING; HEART DISEASE; HEART PACING; HEART PALPITATION; HOLTER MONITORING; HUMAN; HYPERTENSION; LOW DRUG DOSE; MORBIDITY; MUSCLE TONE; ORTHOSTATIC HYPOTENSION; PATHOPHYSIOLOGY; PHYSICAL EXAMINATION; PRACTICE GUIDELINE; RECURRENT DISEASE; SALT INTAKE; SUDDEN DEATH; SUPINE POSITION; SYMPTOM; SYNCOPE; SYSTOLIC BLOOD PRESSURE; TACHYCARDIA; UNCONSCIOUSNESS; ALGORITHM; REVIEW; TILT TABLE TEST;

ALGORITHMS; ELECTROCARDIOGRAPHY; HUMANS; SYNCOPE; TILT-TABLE TEST;

EID: 34848880771     PISSN: 0025729X     EISSN: 13265377     Source Type: Journal    
DOI: 10.5694/j.1326-5377.2007.tb01248.x     Document Type: Article

References (48)

1. Engel GL. Psychologic stress, vasodepressor (vasovagal) syncope, and sudden death. Ann Intern Med 1978; 89: 403-412.
2. Ganzeboom KS, Mairuhu G, Reitsma JB, et al. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35-60 years. J Cardiovasc Electrophysiol 2006; 17: 1172-1176.
3. Colman N, Nahm K, Ganzeboom KS, et al. Epidemiology of reflex syncope. Clin Auton Res 2004; 14 Suppl 1: 9-17.
4. Mathias CJ, Deguchi K, Schatz I. Observations on recurrent syncope and presyncope in 641 patients. Lancet 2001; 357: 348-353.
5. Grubb B, Olshansky B, editors. Syncope: mechanisms and management. 2nd ed. Malden, Mass: Blackwell Futura, 2005.
6. Linzer M, Pontinen M, Gold DT, et al. Impairment of physical and psychosocial function in recurrent syncope. J Clin Epidemiol 1991; 44: 1037-1043.
7. van Dijk N, Sprangers MA, Colman N, et al. Clinical factors associated with quality of life in patients with transient loss of consciousness. J Cardiovasc Electrophysiol 2006; 17: 998-1003.
8. Brignole M, Alboni P, Benditt D, et al. Task force on syncope, European Society of Cardiology. Part 2. Diagnostic tests and treatment: summary of recommendations. Europace 2001; 3: 261-268.
9. Brignole M, Alboni P, Benditt D, et al. Task force on syncope, European Society of Cardiology. Part 1. The initial evaluation of patients with syncope. Europace 2001; 3: 253-260.
10. Colman N, Nahm K, van Dijk JG, et al. Diagnostic value of history taking in reflex syncope. Clin Auton Res 2004; 14 Suppl 1: 37-44.
11. Morillo CA, Eckberg DL, Ellenbogen KA, et al. Vagal and sympathetic mechanisms in patients with orthostatic vasovagal syncope. Circulation 1997; 96: 2509-2513.
12. Sheldon R, Rose S, Connolly S, et al. Diagnostic criteria for vasovagal syncope based on a quantitative history. Eur Heart J 2006; 27: 344-350.
13. Calkins H, Shyr Y, Frumin H, et al. The value of the clinical history in the differentiation of syncope due to ventricular tachycardia, atrioventricular block, and neurocardiogenic syncope. Am J Med 1995; 98: 365-373.
14. Grubb BP. Clinical practice. Neurocardiogenic syncope. N Engl J Med 2005; 352: 1004-1010.
15. Zaidi A, Clough P, Cooper P, et al. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J Am Coll Cardiol 2000; 36: 181-184.
16. Grubb BP, Kosinski DJ, Boehm K, et al. The postural orthostatic tachycardia syndrome: a neurocardiogenic variant identified during head-up tilt table testing. Pacing Clin Electrophysiol 1997; 20: 2205-2212.
17. Goldstein DS, Holmes C, Frank SM, et al. Cardiac sympathetic dysautonomia in chronic orthostatic intolerance syndromes. Circulation 2002; 106: 2358-2365.
18. Goldstein DS, Holmes C, Cannon RO 3rd, et al. Sympathetic cardioneuropathy in dysautonomias. N Engl J Med 1997; 336: 696-702.
19. Courbon F, Brefel-Courbon C, Thalamas C, et al. Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson's disease. Mov Disord 2003; 18: 890-897.
20. Wieling W, Krediet CT, van Dijk N, et al. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond) 2007; 112: 157-165.
21. Ganzeboom KS, Colman N, Reitsma JB, et al. Prevalence and triggers of syncope in medical students. Am J Cardiol 2003; 91: 1006-1008, A8.
22. Brignole M, Alboni P, Benditt DG, et al. Guidelines on management (diagnosis and treatment) of syncope - update 2004. Executive summary. Eur Heart J 2004; 25: 2054-2072.
23. Strickberger SA, Benson DW, Biaggioni I, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation 2006; 113: 316-327.
24. Benditt DG. The ACCF/AHA Scientific Statement on Syncope: a document in need of thoughtful revision. Clin Auton Res 2006; 16: 363-368.
25. Gibbons CH, Freeman R. Delayed orthostatic hypotension: a frequent cause of orthostatic intolerance. Neurology 2006; 67: 28-32.
26. Sun BC, Emond JA, Camargo CA Jr. Inconsistent electrocardiographic testing for syncope in United States emergency departments. Am J Cardiol 2004; 93: 1306-1308.
27. Linzer M, Pritchett EL, Pontinen M, et al. Incremental diagnostic yield of loop electrocardiographic recorders in unexplained syncope. Am J Cardiol 1990; 66: 214-219.
28. Sivakumaran S, Krahn AD, Klein GJ, et al. A prospective randomized comparison of loop recorders versus Holter monitors in patients with syncope or presyncope. Am J Med 2003; 115: 1-5.
29. Brignole M, Sutton R, Menozzi C, et al. Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope. Eur Heart J 2006; 27: 1085-1092.
30. van Dijk N, Quartieri F, Blanc JJ, et al. Effectiveness of physical counter-pressure maneuvers in preventing vasovagal syncope: the Physical Counterpressure Manoeuvres Trial (PC-Trial). J Am Coll Cardiol 2006; 48: 1652-1657.
31. Sheldon R. Tilt testing for syncope: a reappraisal. Curr Opin Cardiol 2005; 20: 38-41.
32. Kapoor WN, Brant N. Evaluation of syncope by upright tilt testing with isoproterenol. A nonspecific test. Ann Intern Med 1992; 116: 358-363.
33. Esler M, Willett I, Leonard P, et al. Plasma noradrenaline kinetics in humans. J Auton Nerv Syst 1984; 11: 125-144.
34. Lambert E, Hotchkin E, Alvarenga M, et al. Single-unit analysis of sympathetic nervous discharges in patients with panic disorder. J Physiol 2006; 570: 637-643.
35. Krediet CT, van Dijk N, Linzer M, et al. Management of vasovagal syncope: controlling or aborting faints by leg crossing and muscle tensing. Circulation 2002; 106: 1684-1689.
36. Raj SR, Rose S, Ritchie D, et al. The Second Prevention of Syncope Trial (POST II) - a randomized clinical trial of fludrocortisone for the prevention of neurally mediated syncope: rationale and study design. Am Heart J 2006; 151: 1186, e11-17.
37. Kaufmann H, Saadia D, Voustianiouk A. Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study. Ann Neurol 2002; 52: 342-345.
38. Sheldon R, Connolly S, Rose S, et al. Prevention of Syncope Trial (POST): a randomized, placebo-controlled study of metoprolol in the prevention of vasovagal syncope. Circulation 2006; 113: 1164-1170.
39. Schroeder C, Birkenfeld AL, Mayer AF, et al. Norepinephrine transporter inhibition prevents tilt-induced pre-syncope. J Am Coll Cardiol 2006; 48: 516-522.
40. Connolly SJ, Sheldon R, Thorpe KE, et al. Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: Second Vasovagal Pacemaker Study (VPS II): a randomized trial. JAMA 2003; 289: 2224-2229.
41. Jacob G, Shannon JR, Black B, et al. Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia. Circulation 1997; 96: 575-580.
42. Freitas J, Santos R, Azevedo E, et al. Clinical improvement in patients with orthostatic intolerance after treatment with bisoprolol and fludrocortisone. Clin Auton Res 2000; 10: 293-299.
43. Hoeldtke RD, Bryner KD, Hoeldtke ME, et al. Treatment of postural tachycardia syndrome: a comparison of octreotide and midodrine. Clin Auton Res 2006; 16: 390-395.
44. Raj SR, Black BK, Biaggioni I, et al. Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome. Circulation 2005; 111: 2734-2740.
45. Olver IN, Jennings GL, Bobik A, et al. Low bioavailability as a cause of apparent failure of dihydroergotamine in orthostatic hypotension. BMJ 1980; 281: 275-276.
46. Low PA, Gilden JL, Freeman R, et al. Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension. A randomized, double-blind multicenter study. Midodrine Study Group. JAMA 1997; 277: 1046-1051.
47. Hoeldtke RD, Streeten DH. Treatment of orthostatic hypotension with erythropoietin. N Engl J Med 1993; 329: 611-615.
48. Shibao C, Gamboa A, Diedrich A, et al. Management of hypertension in the setting of autonomic failure: a pathophysiological approach. Hypertension 2005; 45: 469-476.