Clinical Laboratory Testing: What Is the Role of Tilt-Table Testing, Active Standing Test, Carotid Massage, Electrophysiological Testing and ATP Test in the Syncope Evaluation?

2013 ◽  
Vol 55 (4) ◽  
pp. 418-424 ◽  
Author(s):  
Jean-Jacques Blanc
PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 660-662
Author(s):  
Margaret J. Strieper ◽  
Debbie O. Auld ◽  
J. Edward Hulse ◽  
Robert M. Campbell

Objective. To determine the current practice and effectiveness of evaluating recurrent syncope in pediatric patients, and to establish the role of tilt table testing in the evaluation. Design. Retrospective analysis of 54 pediatric patients with the history of syncope referred to cardiologists. Group I consisted of 27 patients examined without tilt table testing group II consisted of 27 patients whose examination included tilt table testing. Results. Group I had an average of 5.4 studies and group II, 6.6 studies performed per patient. Studies included chest radiograph (16 vs 13), electrocardiogram (24 vs 27), echocardiography (21 vs 27), 24-hour electrocardiogram (14 vs 16), transtelephonic monitor (7 vs 8), electrophysiology study (1 vs 3), complete blood cell counts (11 vs 12), chemistries (10 vs 11), thyroid function test (3 vs 3), neurology consult (12 vs 6), electroencephalogram (12 vs 5), and head computed tomographic scan (5 vs 3). Of the 298 non-tilt studies, the results of only 5 (1.6%) were abnormal. Diagnoses were made in 5 (18.5%) of 27 group I patients (Wolff-Parkinson-White syndrome, 1; conversion reaction, 2; hyperventilation, 1; migraines, 1), whereas diagnosis was made in 27 (100%) of 27 group II patients (neurocardiogenic syncope, 25; conversion reaction, 2). Conclusion. An extensive workup is not routinely indicated in syncopal patients with a history consistent with neurocardiogenic syncope. Tilt table testing performed early in the evaluation will increase the probability of a diagnosis, and will often prevent the need for further extensive, expensive anxiety-producing tests.


2016 ◽  
Vol 2 (7) ◽  
pp. 812-817 ◽  
Author(s):  
Ashish Chaddha ◽  
Kevin E. Wenzke ◽  
Michele Brignole ◽  
Stephen L. Wasmund ◽  
Richard L. Page ◽  
...  

2020 ◽  
Vol 58 (3) ◽  
pp. 350-356 ◽  
Author(s):  
Martina Zaninotto ◽  
Mario Plebani

AbstractThe recently raised concerns regarding biotin interference in immunoassays have increased the awareness of laboratory professionals and clinicians of the evidence that the analytical phase is still vulnerable to errors, particularly as analytical interferences may lead to erroneous results and risks for patient safety. The issue of interference in laboratory testing, which is not new, continues to be a challenge deserving the concern and interest of laboratory professionals and clinicians. Analytical interferences should be subdivided into two types on the basis of the possibility of their detection before the analytical process. The first (type 1) is represented by lipemia, hemolysis and icterus, and the second (type 2), by unusual constituents that are not undetectable before analysis, and may affect the matrix of serum/plasma of individual subjects. Type 2 cannot be identified with current techniques when performing the pre-analytical phase. Therefore, in addition to a more careful evaluation and validation of the method to be used in clinical practice, the awareness of laboratory professionals should be raised as to the importance of evaluating the quality of biological samples before analysis and to adopt algorithms and approaches in the attempt to reduce problems related to erroneous results due to specific or non-specific interferences.


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