Læknablaðið - 15.10.1991, Blaðsíða 12

296
LÆKNABLAÐIÐ
Cardiovascular diseases caused near syncope in
28% of cases. In 14% of cases, drugs caused
the syncope and in 17% with near syncope. A
significant number of patients with an iatrogenic
occurence. In the syncope group 10% of the
patients had an unknown cause, a lower percentage
than in similar, previously published studies.
The most important factor in revealing the
diagnosis was a thorough history and examination,
which gave the diagnosis in over half of cases.
Continuous heart monitoring (48 hour Holter
monitoring) was the second most helpful tool
in arriving at the diagnosis, and an EKG also
proved to be helpful in both groups of patients. An
invasive electrophysiologic study was performed
in 11 selected cases and lead to the diagnosis in 7
patients.
This study demonstrates the importance of near
syncope, since 28% of patients with this symptom
have a serious disorder. The etiologies of syncope
and near syncope are similar and should be
investigated and treated in the same way.
HEIMILDIR
1. Haraldsdóttir V, Ragnarsson J. Orsakir og tíðni
yfirliða. Læknablaðið 1988; 74: 391-6.
2. Eagle KA, Black HR, Cook EF, Goldman L.
Evaluation of prognostic classifications for patients
with syncope. Am J Med 1985; 79: 455-60.
3. Day SC, Cook EF, Funkenstein H, Goldman L.
Evaluation and outcome of emergency room patients
with transient loss of consciousness. Am J Med 1982;
73: 15-23.
4. Kapoor WN, Karpf M, Wieand S, Peterson JR,
Levey GS. A prospective evaluation and follow up
of patients with syncope. N Engl J Med 1983; 309:
197-204.
5. Silverstein MD, Singer DE, Mulley AG, Thibault
GE, Bamett GO. Patients with syncope admitted to
medical intensive care units. JAMA 1982; 248: 1185-
9.
6. Savage DD, Corwin L, McGee DL, Kannel WB,
Wolf PA. Epidemiologic features of isolated syncope.
The Framingham Study. Stroke 1985; 16(4); 626-9.
7. Teichman SL, Felder SD, Matos JA, Kim SG, Waspe
LE, Fisher JD. The value of electrophysiologic
studies in syncope of undetermined origin: Report
of 150 cases. Am Heart J 1985; 110: 469-79.
8. Sugrue DD, Holmes DR, Gersh BJ, Wood DL,
Osbom MJ, Hammill SC. Impact of intracardiac
electrophysiologic testing on the management of
elderly patients with recurrent syncope or near
syncope. J Am Geriatr Soc 1987; 35: 1079-83.
9. Olshansky B, Mazuz M, Martins JB. Significance
of inducible tachycardia in patients with syncope of
unknown origin: A long term follow up. J Am Coll
Cardiol 1985; 5: 216-23.
10. Aonuma K, Iesaka Y, Gosselin AJ. Rozanski JJ,
Lister JW. Cardiac syncope: A case exhibiting
dichotomy between clinical impression and
electrophysiologic evaluation. PACE 1986; 9: 178-87.
11. Denes P, Uretz E, Ezri MD, Borbola J. Clinical
predictors of electrophysiologic findings in patient
with syncope of unknown origin. Arch Intem Med
1988; 148: 1922-8.
12. Jonas S, Klein I, Dimant J. Importance of Holter
monitoring in patients with periodic cerebral
symptoms. Ann Neurol 1977; 1: 470-4.
13. Bass EB, Curtiss EI, Arena VC, et al. The duration
of Holter monitoring in patients with syncope. Is 24
hours enough? Arch Intem Med 1990; 150: 1073-8.
14. Kapoor W, Snustad D, Peterson J, Wieand HS, Cha
R, Karpf M. Syncope in the elderly. Am J Med 1986;
80: 419-28.
15. Lipsitz LA. Syncope in the elderly. Ann Int Med
1983; 99: 92-105.
16. Houdent Ch, Morcamp D, Séréni D, et al. Pronostic
á un an des lipothymies et pertes de connaissance
bréves aprés 65 ans. Etude multicentrique de 188 cas.
Presse Méd 1988; 17: 626-9.
17. Hicks CR. Fundamental concepts in the design of
experiments. Third ed. New York: CBS College
Publishing, 1982: 30-2.
18. Eagle KA, Black HR. The impact of diagnostic tests
in evaluating patients with syncope. Yale J Biol Med
1983; 56: 1-8.
19. Gendelman HE, Linzer M, Gabelman M, Smoller
S, Scheuer J. Syncope in a general hospital patient
population. Usefulness of the radionuclid brain scan,
electroencephalogram and 24-hour Holter monitor.
NY State J Med 1983; 83: 1161-5.
20. Kapoor WN, Karpf M. Maher Y, Miller RA, Levey
GS. Syncope of unknown origin. The need for a more
cost-effective approach to its diagnostic evaluation.
JAMA 1982; 247: 2687-91.
21. Richards AM, Nicholls MG, Ikram H, Hamilton EJ,
Richards RD. Syncope in aortic valvular stenosis.
Lancet 1984; 2: 1113-6.
22. Kapoor WN, Peterson JR, Karpf M. Micturition
syncope. A reappraisal. JAMA 1985; 253: 796-8.
23. Naccarelli GV. Evaluation of the patient with
syncope. Med Clin N Am 1984; 68(5); 1211-30.
24. Kapoor W, Karpf M, Levey GS. Issues in evaluating
patients with syncope. Ann of Int Med 1984; 100:
755-7.
25. Gang ES, Oseran DS, Mandel WJ, Peter T. Sinus
node electrogram in patients with the hypersensitive
carotid sinus syndrome. J Am Coll Cardiol 1985’ 5'
1484-90.
26. Baron SB, Huang SK. Cough syncope presenting
as Mobitz type II atrioventricular block - an
electrophysiologic correlation. PACE 1987; 10' 65-
9.
27. Hamer AWF, Rubin SA, Peter T, Mandel WJ. Factors
that predict syncope during ventricular tachycardia in
patients. Am Heart J 1984; 107: 997-1005.