[Quantitative tilt table study with TCD monitoring. A reliable method for the diagnosis of neurocardiogenic syncope (vasovagal syncope)].

Abstract

The clinical significance of quantitative tilt-table examination with TCD monitoring in the diagnosis of neurocardiogenic syncope is evaluated. A 50-year-old male suffered a neurocardiogenic syncope during tilt-table examination with a strong drop in blood pressure, an increase in cerebrovascular resistance as evidenced by transcranial Doppler monitoring, and a 30-s cardiac asystole, followed by a generalized seizure. No further syncope could be elicited during tilt-table examination after beta-blocker treatment. It was hypothesized that hyperactivity of the left ventricular mechanoreceptors due to increased force of ventricular contraction during a state of reduced venous backstream to the heart was responsible for eliciting the neurocardiogenic syncope. Tilt-table examination with an upright position for at least 45 min enables the diagnosis of a neurocardiogenic syncope to be made with sufficient sensitivity and specificity. Several studies have shown that medication with beta-blockers is successful in the treatment of neurocardiogenic syncope. The implantation of cardiac pacemakers should only be considered if medication is not successful.

• Authors: R R Diehl, P Berlit
• Journal: Der Nervenarzt (Nervenarzt) Vol. 66 Issue 2 Pg. 116-23 (Feb 1995) ISSN: 0028-2804 [Print] Germany
• Vernacular Title: Die quantitative Kipptischuntersuchung mit TCD-Monitoring. Eine reliable Methode zur Diagnose der neurokardiogenen Synkope (vasovagalen Synkope).
• PMID: 7715750 (Publication Type: Case Reports, English Abstract, Journal Article, Review)

Chemical References

• Adrenergic beta-Antagonists

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Arousal (drug effects, physiology)
• Blood Pressure (drug effects, physiology)
• Brain (blood supply)
• Heart Rate (drug effects, physiology)
• Heart Ventricles (drug effects, physiopathology)
• Humans
• Male
• Mechanoreceptors (drug effects, physiopathology)
• Middle Aged
• Pacemaker, Artificial
• Syncope (etiology, physiopathology, therapy)
• Tilt-Table Test
• Ultrasonography, Doppler, Transcranial
• Vagus Nerve (drug effects, physiopathology)
• Vascular Resistance (drug effects, physiology)
• Vasomotor System (drug effects, physiopathology)