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Clinical characteristics of unexplained syncope and their relationship to tilt table test outcomes

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


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Aims To describe the clinical characteristics of patients presenting to a tertiary referral centre undergoing tilt table testing (HUT), comparing those who have vasovagal syncope (VVS) confirmed as a cause of symptoms and those with unexplained syncope after HUT. Design Prospective study of consecutive patients presenting to a regional tertiary referral centre, with more than two episodes of unexplained syncope in the past year. Detailed semi-structured questionnaires were completed regarding presenting symptoms, prodromal features and precipitating factors. Results Eighty-seven patients were studied, 31 had positive passive head up tilt (HUT), 31 positive provocative HUT (either sublingual glyceryl trinitrate or intravenous isoprenaline) and in 25 patients, syncope remained unexplained at the end of tilt testing. Characteristics of patients with positive passive HUT did not differ significantly from those requiring pharmacological provocation, although passive HUT patients were more likely to have classical prodrome and precipitants. The clinical characteristics of those whose syncope remained unexplained differed from those who had VVS confirmed by tilt table testing, in particular symptoms after syncope were less common and clustering of episodes was unlikely. Prodrome was absent in over 80% of the "unexplained" group. Conclusions Clinical characteristics of patients with unexplained syncope and negative tilt tests differ from those with positive tilt studies. Further cardiovascular testing should be undertaken in this group to determine other causes of syncope.

Publication metadata

Author(s): Kenny RA; Graham LA

Publication type: Article

Publication status: Published

Journal: Clinical Autonomic Research

Year: 2002

Volume: 12

Issue: 2

Pages: 88-93

ISSN (print): 0959-9851

ISSN (electronic): 1619-1560

Publisher: Dr. Dietrich Steinkopff Verlag


DOI: 10.1007/s102860200026


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