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1.
Rev Med Liege ; 75(3): 154-158, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32157839

RESUMO

Syncope is a frequent reason for admission to emergency department or consultations. The common pathophysiological mechanism is a drop in systemic blood pressure leading to cerebral hypoperfusion, and ultimately to total loss of consciousness. The causes are multiple, with varying degrees of severity, classified into three main types : reflex syncope, syncope due to orthostatic hypotension and cardiac syncope. Among these, orthostatic hypotension can be easily detected, particularly by performing an orthostatic challenge with active standing, which is recommended in the presence of any syncope. Simple measures can reduce the recurrence of this type of syncope, even if sometimes drug treatments are necessary. In this article, we will detail the characteristics, diagnostic methods and therapies recommended by the latest guidelines of the European Society of Cardiology.


Assuntos
Hipotensão Ortostática , Síncope , Serviço Hospitalar de Emergência , Humanos , Hipotensão Ortostática/complicações , Recidiva , Síncope/diagnóstico , Síncope/etiologia , Síncope/terapia
4.
Herz ; 44(8): 759-768, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31620824

RESUMO

The clarification of syncope is a diagnostic challenge as possible causes often occur only intermittently. Therefore, a detailed and standardized anamnesis is essential as it 1) differentiates syncope from other transient losses of consciousness (TLOC) and 2) directly clarifies possible causes of syncope. The risk stratification plays a central and very important role in order to avoid unnecessary examinations in patients with benign syncope and to provide patients with life-threatening, mostly cardiac syncopal episodes with timely diagnostics and treatment. In cases where the cause of syncope is still unclear, a standardized approach is indicated using extended diagnostics, such as a tilt table examination, a carotid sinus pressure test, prolonged telemetric monitoring or clarification with an implantable loop recorder (ILR).


Assuntos
Síncope , Diagnóstico Diferencial , Eletrocardiografia Ambulatorial , Humanos , Síncope/diagnóstico , Teste da Mesa Inclinada
5.
Int Heart J ; 60(5): 1206-1210, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484877

RESUMO

A 7-year-old female suffering from syncope attacks and deafness was genetically diagnosed with Jervell and Lange-Nielsen syndrome (JLNS). A transvenous-designed shock lead and implantable cardioverter-defibrillator (ICD) were atypically implanted subcutaneously, because the patient's body was small. Six years after implantation, we confirmed the patient's eligibility for a subcutaneous ICD (S-ICD) based on electrocardiogram screening. The implanted ICD system was replaced with a new standard S-ICD system. Implantation of the S-ICD may be considered a reliable and safe option in young patients with JLNS, even if their electrocardiograms show remarkable prolongation of the QT interval and T-wave alternans.


Assuntos
Desfibriladores Implantáveis/efeitos adversos , Eletrocardiografia/métodos , Síndrome de Jervell-Lange Nielsen/diagnóstico , Síndrome de Jervell-Lange Nielsen/terapia , Canal de Potássio KCNQ1/genética , Criança , Remoção de Dispositivo/métodos , Feminino , Seguimentos , Predisposição Genética para Doença , Humanos , Síndrome de Jervell-Lange Nielsen/complicações , Linhagem , Retratamento , Síncope/diagnóstico , Síncope/etiologia , Síncope/terapia , Fatores de Tempo , Resultado do Tratamento
6.
J Assoc Physicians India ; 67(9): 92-93, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31561701

RESUMO

Gitelman's syndrome, or congenital hypokalemic hypomagnesemic hypocalciuria with metabolic alkalosis, is widely described as a benign or milder variant of Barter's syndrome. It presents with variable clinical symptoms including tetanic episodes, muscle cramps, muscle paralysis, tingling numbness, perioral tingling sensation, salt craving and nocturia. This milder salt wasting syndrome can rarely cause significant ventricular arrhythmias and even death. Here, we report a case of 59 year old male who presented with history of recurrent syncope. He was found to have recurrent polymorphic VT with persistent hypokalemia and hypomagnesia. After extensive metabolic investigation, he was diagnosed as a case of Gitelman's syndrome. We report this case because of this rare malignant presentation of a seemingly benign syndrome.


Assuntos
Síndrome de Gitelman/diagnóstico , Síncope/diagnóstico , Alcalose , Síndrome de Bartter , Humanos , Hipopotassemia , Masculino , Pessoa de Meia-Idade
8.
South Med J ; 112(8): 421-427, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31375838

RESUMO

OBJECTIVES: Approximately one in six patients hospitalized with syncope have pulmonary embolism (PE), according to the PE in Syncope Italian Trial study. Subsequent studies using administrative data have reported a PE prevalence of <3%. The aim of the study was to determine the prevalence and predictors of PE in hospitalized patients with syncope. METHODS: We retrospectively reviewed the records of patients who were hospitalized in the MedStar Washington Hospital Center between May 1, 2015 and June 30, 2017 with deep venous thrombosis, PE, and syncope. Only patients who presented to the emergency department with syncope were included in the final analysis. PE was diagnosed by either positive computed tomographic angiography or a high-probability ventilation-perfusion scan. Univariate and multivariate logistic regressions were used to assess the associations between clinical variables and the diagnosis of PE in patients with syncope. RESULTS: Of the 408 patients hospitalized with syncope (mean age, 67.5 years; 51% men [N = 208]), 25 (6%) had a diagnosis of PE. Elevated troponin levels (odds ratio 6.6, 95% confidence interval 1.9-22.9) and a dilated right ventricle on echocardiogram (odds ratio 6.9, 95% confidence interval 2.0-23.6) were independently associated with the diagnosis of PE. Age, active cancer, and history of deep venous thrombosis were not associated with the diagnosis of PE. CONCLUSIONS: The prevalence of PE in this study is approximately one-third of the reported prevalence in the PE in Syncope Italian Trial study and almost three times the value reported in administrative data-based studies. PE should be suspected in patients with syncope and elevated troponin levels or a dilated right ventricle on echocardiogram.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Pacientes Internados , Embolia Pulmonar/epidemiologia , Medição de Risco/métodos , Síncope/complicações , Idoso , Angiografia , District of Columbia/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Estudos Retrospectivos , Fatores de Risco , Síncope/diagnóstico , Tomografia Computadorizada por Raios X
9.
Rev Invest Clin ; 71(4): 226-236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448784

RESUMO

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a potentially lethal disease, whose characteristic ventricular tachycardias are adrenergic-dependent. Although rare, CPVT should be considered in the differential diagnosis of young individuals with exercise-induced syncope. Mutations in five different genes (RYR2, CASQ2, CALM1, TRDN, and TECRL) are associated with the CPVT phenotype, although RYR2 missense mutations are implicated in up to 60 % of all CPVT cases. Genetic testing has an essential role in the diagnosis, management, pre-symptomatic diagnosis, counseling, and treatment of the proband; furthermore, genetic information can be useful for offspring and relatives. By expert consensus, CPVT gene testing is a Class I recommendation for patients with suspected CPVT. Beta-adrenergic and calcium-channel blockers are the cornerstones of treatment due to the catecholaminergic dependence of the arrhythmias. Unresponsive patients are treated with an implantable cardioverter-defibrillator to reduce the risk of sudden cardiac death. In the present article, a brief review of the genetic and molecular mechanisms of this intriguing disease is provided.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Taquicardia Ventricular/diagnóstico , Diagnóstico Diferencial , Testes Genéticos , Humanos , Mutação , Síncope/diagnóstico , Taquicardia Ventricular/genética , Taquicardia Ventricular/terapia
10.
BMJ Case Rep ; 12(7)2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31340940

RESUMO

A 30-year-old nulliparous woman at 38 5/7 weeks of gestation developed a sudden, severe headache at work and subsequent loss of consciousness. She underwent evaluation in the emergency department. CT and CT angiogram head revealed a large intraparenchymal haematoma with intraventricular extension secondary to ruptured cerebral arteriovenous malformation (cAVM). She was intubated and transferred to a tertiary care centre. The patient underwent caesarean section followed by partial embolisation of the cAVM with planned second embolisation and resection 1 week later. Due to drowsiness and headache, the planned repeat embolisation and cAVM resection were performed 3 days earlier. The patient had a full recovery. Emergency medicine physicians and obstetrician-gynaecologists should be familiar with differential diagnosis of sudden headache in pregnancy and signs of a ruptured cAVM to facilitate early diagnosis, multidisciplinary team approach and timely treatment. Early diagnosis and management of ruptured cAVM are important due to associated morbidity and mortality.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Embolização Terapêutica/métodos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/terapia , Ruptura Espontânea/terapia , Adulto , Cesárea , Serviço Hospitalar de Emergência , Feminino , Seguimentos , Idade Gestacional , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Malformações Arteriovenosas Intracranianas/fisiopatologia , Gravidez , Resultado da Gravidez , Medição de Risco , Ruptura Espontânea/diagnóstico por imagem , Síncope/diagnóstico , Síncope/etiologia
11.
Hypertension ; 74(3): 645-651, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31327266

RESUMO

Alpha-blockers (ABs) are commonly prescribed as part of a multidrug regimen in the management of hypertension. We set out to assess the risk of hypotension and related adverse events with AB use compared with other blood pressure (BP) lowering drugs using a population-based, retrospective cohort study of women (≥66 years) between 1995 and 2015 in Ontario, Canada. Cox proportional hazards examined the association of AB use and hypotension and related events (syncope, fall, and fracture) compared with other BP lowering drugs matched via a high dimensional propensity score. The primary outcome was a composite of hospitalizations for hypotension and related events (syncope, fractures, and falls) within 1 year. From 734 907 eligible women, 14 106 were dispensed an AB (mean age, 75.7; standard deviation 6.9 years, median follow-up 1 year) and matched to 14 106 dispensed other BP lowering agents. The crude incidence rate of hypotension and related events was 95.7 (95% CI [confidence interval], 90.4-101.1, events 1214 [8.6%]) with AB and 79.8 (95% CI, 74.9-84.7 per 1000 person-years, events 1025 [7.3%]) with other BP lowering medications (incident rate ratio, 1.20; 95% CI, 1.10-1.30). The risk was higher for hypotension (hazard ratio, 1.71; 95% CI, 1.33-2.20) and syncope (hazard ratio, 1.44; 95% CI, 1.18-1.75) with no difference in falls, fractures, adverse cardiac events, or all-cause mortality. Treatment of hypertension in women with ABs is associated with a higher risk of hypotension and hypotension-related events compared with other BP lowering agents. Our findings suggest that ABs should be used with caution, even as add on therapy for hypertension.


Assuntos
Antagonistas Adrenérgicos alfa/efeitos adversos , Hipertensão/tratamento farmacológico , Hipotensão/induzido quimicamente , Hipotensão/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Antagonistas Adrenérgicos alfa/uso terapêutico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Canadá , Estudos de Coortes , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/epidemiologia , Avaliação Geriátrica/métodos , Humanos , Hipertensão/diagnóstico , Hipotensão/fisiopatologia , Incidência , Prognóstico , Pontuação de Propensão , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Síncope/diagnóstico , Síncope/epidemiologia , Resultado do Tratamento
12.
Dtsch Med Wochenschr ; 144(15): 1040-1043, 2019 08.
Artigo em Alemão | MEDLINE | ID: mdl-31350745

RESUMO

Syncope is one of the most frequent mode of hospital visits in the emergency department. A broad range of causalities and healthcare economic efficiency have demanded reasonable road maps for diagnostic procedures and hospital admission of patients with syncope. Recent advances and multidisciplinary assessments provided the basis of the updated 2018 ESC Guidelines for the diagnosis and management of syncope. While the definitions of syncope remain unchanged these updates state risk stratification in the emergency department with clear diagnostic paths and monitoring in the current era with portable devices. The algorithm for reflex syncope therapy, indication for cardiac pacemakers and implantable cardioverter-defibrillators in high-risk patients for sudden cardiac death were modified. Finally, the updated guidelines recommend an establishment of "syncope-unit" with multidisciplinary involvement.


Assuntos
Síncope , Determinação da Pressão Arterial , Cardiologia/organização & administração , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Eletrocardiografia , Europa (Continente) , Humanos , Marca-Passo Artificial , Guias de Prática Clínica como Assunto , Síncope/diagnóstico , Síncope/etiologia , Síncope/fisiopatologia , Síncope/terapia
13.
Lakartidningen ; 1162019 Feb 19.
Artigo em Sueco | MEDLINE | ID: mdl-31192373

RESUMO

Syncope is the chief complaint in 1-2 percent of emergency department visits. Syncope belongs to the broader category transient loss of consciousness (TLOC), defined as a short loss of consciousness with loss of awareness and responsiveness, and with subsequent amnesia for the event. Syncope is defined as TLOC due to cerebral hypoperfusion, with rapid onset and spontaneous complete recovery. The main categories of syncope are reflex syncope, orthostatic hypotension, and cardiac syncope. The 2018 guidelines by the European Society of Cardiology emphasizes the process of risk stratification in the initial management of suspected syncope. Risk stratification serves to separate the patients with likely orthostatic and reflex syncope with good prognosis from the patients with likely cardiac syncope and high short-term risk of an adverse outcome. It determines the appropriate next level of care. Further evaluation should be based on clinical suspicion and frequency of symptoms.


Assuntos
Síncope/diagnóstico , Cardiologia , Procedimentos Clínicos , Diagnóstico Diferencial , Gerenciamento Clínico , Europa (Continente) , Humanos , Hipotensão Ortostática/diagnóstico , Hipotensão Ortostática/etiologia , Hipotensão Ortostática/terapia , Guias de Prática Clínica como Assunto , Medição de Risco , Sociedades Médicas , Síncope/etiologia , Síncope/terapia , Síncope Vasovagal/diagnóstico , Síncope Vasovagal/etiologia , Síncope Vasovagal/terapia
14.
Undersea Hyperb Med ; 46(1): 7-16, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31154681

RESUMO

Purpose: This study examined the independent effects of cold-water submersion and a rehydration strategy on an aerobic endurance performance and orthostatic tolerance following a four-hour dive in cold water (10°C). Methods: Nine male subjects completed a control (CON) performance and lower-body negative pressure test (LBNP) and two water immersion visits with either no rehydration (NR) or a post-immersion rehydration (RH) with 1 L of water. Following submersion, subjects ran to exhaustion and submitted to LBNP. Results: Core body temperature declined during submersion and remained reduced from baseline until the run (P ⟨ 0.001) and was not different between NR and RH (P = 0.13). Total urine output during submersion was not different between groups (1.69 ± 0.49 (NR), 1.75 ± 0.52 (RH) L; P = 0.74) eliciting a body mass reduction of -2.2 ± 0.3 and -0.8 ±; 0.3% (P ⟨ 0.01), respectively. Run duration was not different (547 ± 141 (NR), 566 ± 152 (RH) s; P = 0.79); however, both NR and RH run duration was shorter compared to CON (722 ± 170 s; P = 0.04). Cumulative stress index was suppressed in NR (534 ± 163 mmHg*min) and RH (591 ± 129 mmHg*min) compared to CON (707 ± 170 mmHg*min, P V#8804; 0.03), with no differences between submersion trials (P = 0.23). Conclusion: Compared to a non-submersed state, run duration and orthostatic tolerance was reduced following a four-hour cold-water submersion. Rehydration with 1 L of water following submersion did not offer a performance advantage over no rehydration.


Assuntos
Temperatura Corporal/fisiologia , Temperatura Baixa/efeitos adversos , Hidratação/métodos , Imersão , Resistência Física/fisiologia , Corrida/fisiologia , Água , Análise de Variância , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Água Potável , Eletrocardiografia , Frequência Cardíaca/fisiologia , Humanos , Pressão Negativa da Região Corporal Inferior , Masculino , Decúbito Dorsal/fisiologia , Síncope/diagnóstico , Fatores de Tempo , Micção , Urina , Perda de Peso , Adulto Jovem
15.
Dtsch Med Wochenschr ; 144(12): 835-841, 2019 06.
Artigo em Alemão | MEDLINE | ID: mdl-31212327

RESUMO

Transient loss of consciousness (TLOC) is a frequent cause of referral to an emergency room. In view of the impact on treatment and the patients' daily life activities (e. g. profession, driving license), an accurate and timely diagnosis is of uttermost importance. This article provides key features and suggests a practical step-by-step approach of how to differentiate syncope, epileptic and psychogenic non-epileptic seizures as the commonest causes of nontraumatic TLOC.


Assuntos
Epilepsia , Convulsões , Síncope , Diagnóstico Diferencial , Epilepsia/classificação , Epilepsia/diagnóstico , Humanos , Convulsões/classificação , Convulsões/diagnóstico , Síncope/classificação , Síncope/diagnóstico
17.
J Int Adv Otol ; 15(1): 135-140, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31058603

RESUMO

OBJECTIVES: The aim of the current study was to further collect evidence that would confirm the hypothesis that vestibular drop attacks (VDAs) could cause syncope in patients with Ménière's disease (MD). MATERIALS AND METHODS: A cross-sectional survey design was employed in the present study. An Internet-based survey was administered on 602 individuals with MD. The mean age of the participants was 56.7 (25-75) years, and the mean duration of the disease was 12.4 (0.5-35) years. RESULTS: VDAs with varying severity were present among 307 (50.7%) patients and led to fall in 92 patients, and syncope occurred in 45 patients with VDA. The overall percentage of syncope due to MD was 4.7%. Factors, such as duration of disease, age, and gender of the patient, did not explain attacks of syncope. Migraine and headache were not associated with syncope. Syncope was witnessed in 23 and self-reported by 22 patients. Syncope was associated with frequent VDA, duration of VDA, and falls that occurred during VDA. Patients with syncope reported the experience as frightening, had reduced general health-related quality of life, had higher anxiousness scores, and suffered more from fatigue. They also experienced problems with work, employment, and social restrictions. CONCLUSION: Approximately 5% of patients with MD suffer from syncope, and syncope occurs among patients with VDA. In vestibular syncope, the sympathetic tone is lost, and baroreflex feedback is inhibited leading to fall and syncope. The consequences of vestibular syncope are severe, and patients face injuries and a significantly reduced quality of life.


Assuntos
Doença de Meniere/diagnóstico , Síncope/diagnóstico , Doenças Vestibulares/complicações , Adulto , Idoso , Barorreflexo , Estudos Transversais , Feminino , Humanos , Masculino , Doença de Meniere/complicações , Doença de Meniere/fisiopatologia , Pessoa de Meia-Idade , Qualidade de Vida , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários , Sistema Nervoso Simpático/fisiopatologia , Síncope/etiologia , Síncope/psicologia , Vestíbulo do Labirinto/fisiopatologia
18.
Med J Aust ; 210(11): 507-508.e3, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31066057

RESUMO

BACKGROUND: Syncope is a common problem but can have any of a broad range of underlying causes. Initial evaluation of the patient in the emergency department often does not identify a specific cause, and the cornerstone of management is reliable risk stratification with clinical decision rules. OBJECTIVES: The primary objective is to validate the utility and safety of the Canadian Syncope Risk Score (CSRS) as a clinical decision rule when assessing patients who present with syncope to Australian emergency departments. Our secondary objective is to evaluate the economic benefits of diverting patients with syncope at low risk of serious adverse events from admission to hospital. METHODS AND ANALYSIS: Prospective, observational study. Patients aged 18 years or more who present to the emergency department (ED) after syncope in the preceding 24 hours and have returned to their baseline state will be enrolled. Patients will be contacted by telephone to determine whether they have experienced any adverse events within 30 days of their initial presentation to the ED. The CSRS will be applied retrospectively to determine the relationship between whether patients were admitted to hospital or discharged home and the reporting of serious adverse events for each CSRS risk level. We will also undertake a cost-effectiveness analysis from the health care perspective. ETHICS APPROVAL: Prince Charles Hospital Human Research Ethics Committee (reference, HREC/17/QPCH/48). DISSEMINATION OF RESULTS: Outcomes will be disseminated by Queensland Health and the funding body via social media, presented at local and national emergency medicine conferences, and published in international emergency medicine and health economics journals. CLINICAL TRIALS REGISTRATION: Not applicable.


Assuntos
Serviço Hospitalar de Emergência , Medição de Risco/métodos , Síncope/diagnóstico , Humanos , Estudos Prospectivos , Queensland , Projetos de Pesquisa , Fatores de Risco
19.
J Am Coll Cardiol ; 73(14): 1756-1765, 2019 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-30975291

RESUMO

BACKGROUND: Information on young patients with Brugada syndrome (BrS) and arrhythmic events (AEs) is limited. OBJECTIVES: The purpose of this study was to describe their characteristics and management as well as risk factors for AE recurrence. METHODS: A total of 57 patients (age ≤20 years), all with BrS and AEs, were divided into pediatric (age ≤12 years; n = 26) and adolescents (age 13 to 20 years; n = 31). RESULTS: Patients' median age at time of first AE was 14 years, with a majority of males (74%), Caucasians (70%), and probands (79%) who presented as aborted cardiac arrest (84%). A significant proportion of patients (28%) exhibited fever-related AE. Family history of sudden cardiac death (SCD), prior syncope, spontaneous type 1 Brugada electrocardiogram (ECG), inducible ventricular fibrillation at electrophysiological study, and SCN5A mutations were present in 26%, 49%, 65%, 28%, and 58% of patients, respectively. The pediatric group differed from the adolescents, with a greater proportion of females, Caucasians, fever-related AEs, and spontaneous type-1 ECG. During follow-up, 68% of pediatric and 64% of adolescents had recurrent AE, with median time of 9.9 and 27.0 months, respectively. Approximately one-third of recurrent AEs occurred on quinidine therapy, and among the pediatric group, 60% of recurrent AEs were fever-related. Risk factors for recurrent AE included sinus node dysfunction, atrial arrhythmias, intraventricular conduction delay, or large S-wave on ECG lead I in the pediatric group and the presence of SCN5A mutation among adolescents. CONCLUSIONS: Young BrS patients with AE represent a very arrhythmogenic group. Current management after first arrhythmia episode is associated with high recurrence rate. Alternative therapies, besides defibrillator implantation, should be considered.


Assuntos
Arritmias Cardíacas , Síndrome de Brugada , Parada Cardíaca , Quinidina/uso terapêutico , Medição de Risco/métodos , Prevenção Secundária/métodos , Técnicas de Ablação/métodos , Adolescente , Antiarrítmicos/uso terapêutico , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/genética , Arritmias Cardíacas/prevenção & controle , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/epidemiologia , Síndrome de Brugada/fisiopatologia , Síndrome de Brugada/terapia , Criança , Desfibriladores Implantáveis/estatística & dados numéricos , Eletrocardiografia/métodos , Técnicas Eletrofisiológicas Cardíacas/métodos , Feminino , Parada Cardíaca/diagnóstico , Parada Cardíaca/prevenção & controle , Humanos , Masculino , Anamnese/estatística & dados numéricos , Fatores de Risco , Síncope/diagnóstico , Síncope/epidemiologia , Síncope/etiologia , Adulto Jovem
20.
Ideggyogy Sz ; 72(3-4): 111-114, 2019 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-30957465

RESUMO

Background and purpose: Syncope is defined as a brief transient loss of consciousness due to cerebral hypoperfusion. Although the diagnosis of syncope is based on a thorough history and examination, electroencaphalography (EEG) is also an important investigational tool in the differential diagnosis in this group of patients. In this study we aimed to identify the diagnostic value of EEG in patients with syncope. Methods: We retrospectively examined EEG recordings of 288 patients with the diagnosis of syncope referred to the Cankiri State Hospital EEG laboratory, from January 2014 to January 2016. The EEG findings were classified into 6 groups as normal, epileptiform discharges (spike and sharp waves), generalized background slowing, focal slowing, hemispherical asymmetries, and low amplitude EEG tracing. The EEGs were separated according to gender and age. Results: Total of 288 patients were included in this study, 148 were females (51.4%) and 140 (48.6%) were males. Among all the EEG reports, 203 (70.5%) were normal, 8 of them (2.8%) showed generalized background slowing and 7 (2.4%) demonstrated focal slow waves. Epileptiform discharges occured among 13 patients (4.5%). Hemispherical asymmetries were detected in 10 patients (3.5%) and low amplitude EEG tracing in 47 patients (16.3%). There was no significant difference between age groups in EEG findings (p=0.3). Also no significant difference was detected in EEG results by gender (p=0.2). Conclusion: Although the diagnosis of syncope, epilepsy and non-epileptic seizures is clinical diagnosis, EEG still remains additional method.


Assuntos
Eletroencefalografia , Epilepsia/diagnóstico , Síncope/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Convulsões , Síncope/fisiopatologia
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