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Clinical characteristics of patients with vasovagal reactions presenting as unexplained syncope

Lookup NU author(s): Dr Laura Graham, Professor Rose Anne Kenny

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Abstract

Objective To describe the clinical characteristics of vasovagal syncope (VVS) in patients presenting to a tertiary referral centre with unexplained syncope, in whom the diagnosis of WS was confirmed by tilt table testing (HUT) and in whom other causes of syncope excluded. Design Prospective study of 62 consecutive patients with more than two episodes of syncope in the past year. Setting A regional tertiary referral centre for patients with unexplained syncope. Patients Sixty-two patients, mean age 50 +/- 21 years, 39 female, were studied. Mean duration of symptoms was 5 years. Average frequency of attacks was one episode per week. Interventions Detailed semi-structured questionnaires were completed regarding presenting symptoms. Results In over one-third of patients, episodes occurred suddenly, with no prodromal features. In those with prodrome. 71% had autonomic symptoms, but 27% had palpitations or dyspnoea and 21% had chest pain. Eleven percent of patients denied known provocative features. In the remainder, the most common were prolonged standing (37%), hot weather (27%) and lack of food (23%). One-fifth had symptoms sitting and 5% whilst driving. Seventy-five percent of patients suffered after effects, the most common being severe fatigue. Over half sustained an injury during syncope, and 13% sustained a fracture. Unwitnessed episodes occurred in 25%. Pallor was reported in half the cases, sweating in 13% and myoclonus in 5%. Conclusions Atypical presentations of WS occur in many patients referred to a tertiary referral centre. Knowledge of the clinical characteristics of unexplained syncope for which WS is the attributable diagnosis should assist in appropriate management of such patients. (Europace 2001; 3: 141-146) (C) 2001 The European Society of Cardiology.

Publication metadata

Author(s): Kenny RA; Graham LA

Publication type: Article

Publication status: Published

Journal: Europace

Year: 2001

Volume: 3

Issue: 2

Pages: 141-146

ISSN (print): 1099-5129

ISSN (electronic): 1532-2092

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1053/eupc.2001.0155

DOI: 10.1053/eupc.2001.0155

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