Diagnosis of neurally mediated syncope at initial evaluation and with tilt table testing compared with that revealed by prolonged ECG monitoring. An analysis from the Third International Study on Syncope of Uncertain Etiology (ISSUE-3)

Heart ◽  
2013 ◽  
Vol 99 (24) ◽  
pp. 1825-1831 ◽  
Author(s):  
Andrea Ungar ◽  
Paolo Sgobino ◽  
Vitantonio Russo ◽  
Elena Vitale ◽  
Richard Sutton ◽  
...  
Keyword(s):  
International Study ◽  
Initial Evaluation ◽  
Ecg Monitoring ◽  
Tilt Table ◽  
The Third ◽  
Neurally Mediated Syncope ◽  
Tilt Table Testing ◽  
Uncertain Etiology

The Use of Transcranial Doppler during Tilt Table Testing in Children Presenting with Syncope

2007 ◽  
Vol 31 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Heather A. Nicoletto ◽  
Mark W. Ellis ◽  
Daniel T. Laskowitz ◽  
Ronald J. Kanter ◽  
April E. Perry ◽  
...  
Keyword(s):  
Transcranial Doppler ◽  
Psychiatric Treatment ◽  
Cerebral Arteries ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Multimodal Monitoring ◽  
Neurally Mediated Syncope ◽  
Middle Cerebral Arteries ◽  
Tilt Table Testing ◽  
Flow Velocities

Childhood syncope is common, and there are three categories of causes of syncope: noncardiovascular pseudosyncope, cardiovascular syncope, and neurally mediated syncope. Tilt table testing has become a valuable tool in the evaluation for the cause of syncope in children. Adding transcranial Doppler (TCD) to the tilt table test to monitor the middle cerebral arteries (MCA) adds valuable information about the cerebral blood flow during a syncopal episode and can help the physician differentiate between the various causes of syncope. Three children with frequent syncopal episodes were evaluated using tilt table testing with multimodal monitoring, including TCD. One child, during her syncopal episode, had an increase in blood pressure, heart rate, and MCA flow velocities. This finding was consistent with noncardiovascular pseudosyncope, and she was sent for psychiatric treatment. The other two patients had hypotension, bradycardia, a significant decrease in MCA flow velocities, and an increase in pulsatility indices. Additionally, one of them experienced a 6-sec period of asystole. Both were diagnosed with neurally mediated syncope and were placed on fludrocortisone and a water and salt regimen.

Isolated very low QRS voltage predicts response to tilt‐table testing in patients with neurally mediated syncope

2019 ◽  
Vol 42 (12) ◽  
pp. 1558-1565
Author(s):  
Dan Blendea ◽  
Craig A. McPherson ◽  
Sorin Pop ◽  
Florin P. Anton ◽  
Sorin Crisan ◽  
...  
Keyword(s):  
Tilt Table ◽  
Neurally Mediated Syncope ◽  
Tilt Table Testing

scholarly journals Evaluation and Management of Reflex Vasovagal Syncope—A Review

2021 ◽  
pp. 263246362110501
Author(s):  
Ameya Udyavar ◽  
Saurabh Deshpande
Keyword(s):  
Diagnostic Tests ◽  
Vasovagal Syncope ◽  
Ecg Monitoring ◽  
Single Test ◽  
Tilt Table ◽  
High Risk Factors ◽  
Cardiac Syncope ◽  
Tilt Table Testing ◽  
Electrocardiogram Ecg

Syncope is a symptom that is commonly encountered in the practice and may point to a cardiac or neurological diagnosis. The evaluation of syncope rests on a thorough clinical evaluation, aided by electrocardiogram (ECG) findings, followed by risk stratification of the particular case. Once high-risk factors have been ruled out, the patient can be further diagnosed as having a reflex syncope (RS), orthostatic hypotension, or cardiac syncope based on specific clues. If the initial evaluation is not confirmatory various diagnostic tests may be used to guide further management (eg, long-term ECG monitoring, tilt table testing, etc). The management should be based on the overall profile of the patient and not only on any single test. In this review, we discuss the evaluation of a patient with RS and give an overview of treatments available for the patients.

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