Skip to main content

Synkope

  • Chapter
  • 243 Accesses

Zusammenfassung

Häufig liest man in Arztbriefen die Formulierung „unklare Synkope“. Es gelang keine Diagnosestellung, obwohl z.T. erheblicher Aufwand betrieben wurde. Dieses Kapitel will v.a. praxisbezogene Empfehlungen zur Abklärung der Ursache und Einschätzung der Prognose nach Synkopen vermitteln.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   299.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   379.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Alboni P, Brignole M, Menozzi C et al (2001) The diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol 37:1921–1928

    Article  PubMed  CAS  Google Scholar 

  • Ascheim DD, Markowitz SM, Lai H et al (1997) Exertional syncope caused by left main coronary artery Spasm. Am Heart J 123:792–794

    Google Scholar 

  • Benditt DG, Gornick CC; Dunbar D et al (1987) Indications for electrophysiologic testing in the diagnosis and assessment of sinus node dysfunction. Circulation 75(Supp lll):93–102

    Google Scholar 

  • Bergfeldt L, Edvardsson N, Rosenquist M et al (1994) Atrioventricular block progression in patients with bifascicular block assessed by repeated electrocardiography and a bradycardia-detecting pacemaker. Am J Cardiol 74:1129–1132

    Article  PubMed  CAS  Google Scholar 

  • Brignole M, Menozzi C, Gianfranchi L et al (1991) Carotid sinus massage, eyeball compression, and head-up tilt test in patients with syncope of uncertain origin and in healthy control subjects. Am Heart J 122:1644–1651

    Article  PubMed  CAS  Google Scholar 

  • Brignole M, Menozzi C, Del Rosso A et al (2000) New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Vasovagal Syncope International Study. Europace 2:66–76

    Article  PubMed  CAS  Google Scholar 

  • Brignole M, Alboni P, Benditt D et al (2001a) Guidelines on management (diagnosis and treatment) of syncope. Eur Heart J 22:1256–1306

    Article  PubMed  CAS  Google Scholar 

  • Brignole M, Menozzi C, Moya A et al. (2001b) Mechanism of syncope in patients with bundle branch block and negative electrophysiological test: ISSUE Investigators. Circulation 104:2045–2050

    Article  PubMed  CAS  Google Scholar 

  • Brugada J, Brugada R, Antzelevitch C (2002) Long-term follow-up of individuals with the electrocardiographic pattern of right bundle branch block and ST-segment elevation in precordial leads V1 to V3. Circulation 105:73–78

    Article  PubMed  Google Scholar 

  • Calkins H, Shyr Y, Frumin H et al (1995) The value of the clinical history in the differentiation of syncope due to ventricular tachycardia, atrioventricular block, and neurocardiogenic syncope. Am J Med 98:365–373

    Article  PubMed  CAS  Google Scholar 

  • Colivicchi F, Ammirati F, Biffi A et al (2002) Exercise related syncope in young competitive athletes without evidence of structural heart disease. Clinical presentation and long-term outcome. Eur Heart J 23:1125–1130

    Article  PubMed  CAS  Google Scholar 

  • Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 46:1470

    Article  Google Scholar 

  • Davies AJ, Kenny RA (1998) Frequency of neurologic complications following carotid sinus massage. Am J Cardiol 81:1256–1257

    Article  PubMed  CAS  Google Scholar 

  • Del Rosso A, Bartoletti A, Bartoli P et al (2000) Methodology of head-up tilt testing potentiated with sublingual nitroglycerin in unexplained syncope. Am J Cardiol 85:1007–1011

    Article  PubMed  Google Scholar 

  • Englund A, Bergfeldt L, Rehnqvist N et al (1995) Diagnostic value of programmed ventricular stimulation in patients with bifascicular block: a prospective study of patients with and without syncope. J Am Coll Cardiol 26:1508–1515

    Article  PubMed  CAS  Google Scholar 

  • Flevari P, Livanis EG, Theodorakis GN et al (2002) Vasovagal syncope: A prospective, randomized, crossover evaluation of the effect of propranolol, nadolol and placebo on syncope recurrence and patients’ well-being. J Am Coll Cardiol 40:499–504

    Article  PubMed  CAS  Google Scholar 

  • Grubb BP, Gerard G, Wolfe DA et al. (1992) Syncope and seizure of psychogenie origin: Identification head-upright tilt table testing. Clin Cardiol 15:839–842

    Article  PubMed  CAS  Google Scholar 

  • Hamer AW, Rubin SA, Peter T, Mandel WJ (1984) Factors that predict syncope during ventricular tachycardia in patients. Am Heart J 107: 997–1005

    Article  PubMed  CAS  Google Scholar 

  • Kalusche D, Ott P, Arentz T et al (1998) AV nodal re-entry tachycardia in elderly patients: clinical presentation and results of radiofrquency ablation therapy. Coronary Artery Dis 9:359–363

    Article  CAS  Google Scholar 

  • Kapoor WN (1992) Evaluation and management of the patient with syncope. J Am Med Ass 268:2553–2560

    Article  CAS  Google Scholar 

  • Kapoor W, Fortunato M, Hanusa BH, Schulberg HC (1995) Psychiatric illness in patients with syncope. Am J Med 99:505–512

    Article  PubMed  CAS  Google Scholar 

  • Kapoor WN (1998) An overview of the evaluation and management of syncope. In Grubb BP, Olshansky B (eds) Syncope: Mechanisms and management, p 1. Futura, Armonk NY

    Google Scholar 

  • Kaul U, Dev V, Narula J et al (1988) Evaluation of patients with bundle branch block and „unexplained“ syncope: a study based on comprehensive electrophysiologic testing and ajmaline stress. Pacing Clin Electrophysiol 11:289–297

    Article  PubMed  CAS  Google Scholar 

  • Kenny RA, Ingram A, Bayliss J, Sutton R (1986) Head-up tilt: a useful test for investigating unexplained syncope. Lancet 1:1352–1355

    Article  PubMed  CAS  Google Scholar 

  • Knight BP, Goyal R, Pelosi F et al (1999) Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator. J Am Coll Cardiol 33:1964–1970

    Article  PubMed  CAS  Google Scholar 

  • Kovac JD, Morgantroyd FD, Skehan JD (1997) Recurrent syncope due to complete atrioventricular block, a rare presenting symptom of otherwise silent coronary artery disease: Successful treatment by PTCA. Cathet Cardiovasc Diagn 42:216–218

    Article  PubMed  CAS  Google Scholar 

  • Krahn AD, Klein GJ, Yee R et al (1999) Use of extended monitoring strategy in patients wirth problematic syncope: Reveal investigators. Circulation 99:406–410

    Article  PubMed  CAS  Google Scholar 

  • Krahn AD, Klein GJ, Yee R, Skates AC (2001) Randomized assessment of syncope trial. Conventional diagnostic testing versus a prolonged monitoring strategy. Circulation 104:46–51

    Article  PubMed  CAS  Google Scholar 

  • Krediet CTP, van Dijk N, Linzer M et al (2002) Management of vasovagal syncope. Controlling or aborting faints by leg crossing and muscle tensing. Circulation 106:1684–1689

    Article  PubMed  Google Scholar 

  • Kushner JA, Kou WH, Kadish AH, Morady F (1989) Natural history of patients with unexplained syncope and a nondiagnostic electrophysiologic study. J Am Coll Cardiol 14:391–396

    Article  PubMed  CAS  Google Scholar 

  • Lempert T, Bauer M, Schmidt D (1994) Syncope: A videometric analysis of 56 episodes of transient cerebral hypoxia. Ann Neurol 36:233–237

    Article  PubMed  CAS  Google Scholar 

  • Linzer M, Felder A, Hackel A et al. (1990) Psychiatric syncope: A new look at an old disease. Psychosomatics 31:181–188

    Article  PubMed  CAS  Google Scholar 

  • Linzer M, Yang EH, Estes NA 3rd et al (1997) Diagnosing syncope. Part 2: Unexplained syncope. Clinical Efficacy assessment project of the american college of physicians. Ann Intern Med 127:76–86

    Google Scholar 

  • Lipsitz LA, Pluchino FC, Wei JY, Rowe JW (1985) Syncope in institutionalized elderly: the impact of multiple pathological conditions and situational stress. J Chronic Dis 39:619–630

    Article  Google Scholar 

  • Maddens M, Lipsitz LA, Wei JY et al (1987) Impaired heart rate response to cough and deep breathing in elderly patients with unexplained syncope. Am J Cardiol 60:1368–1372

    Article  PubMed  CAS  Google Scholar 

  • Maloney JD, Jaeger FJ, Fouad-Tarazi FM, Morris HH (1988) Malignant vasovagal syncope: prolonged asystole provoked by head-up tilt. Case report and review of diagnosis, pathophysiology, and therapy. Cleve Clin J Med 55:542–548

    PubMed  CAS  Google Scholar 

  • Martin GJ, Adams SL, Martin HG et al (1984) Prospective evaluation of syncope. Ann Emerg Med 13:499–504

    Article  PubMed  CAS  Google Scholar 

  • Middlekauff HR, Stevenson WG, Saxon LA (1993a) Prognosis after syncope: impact of left ventricular function. Am Heart J 125:121–127

    Article  PubMed  CAS  Google Scholar 

  • Morady F, Shen EN, Bhandari A, Schwartz AB, Scheinman MM (1985) Clinical symptoms in patients with sustained ventricular tachycardia. West J Med 142:341–344

    PubMed  CAS  Google Scholar 

  • Morillo CA, Leitch JW, Yee R, Klein GJ (1993) A placebo-controlled trial of intravenous and oral disopyramide for prevention of neurally mediated syncope induced by head-up tilt. J Am Coll Cardiol 22: 1843–1848

    Article  PubMed  CAS  Google Scholar 

  • Moya A, Permanyer-Miralda G, Sagrista-Sauleda J et al (1995) Limitations of head-up tilt test for evaluating the efficacy of therapeutic interventions in patients with vasovagal syncope: results of a controlled study of etilefrine versus placebo. J Am Coll Cardiol 25: 65–69

    Article  PubMed  CAS  Google Scholar 

  • Olshansky B (1998) Syncope: Overview and approach to management. In Grubb BP, Olshansky B (eds) Syncope: Mechanisms and management, p 15. Futura Armonk, New York

    Google Scholar 

  • Panther R, Mahmood S, Gal R (1998) Echocardiography in the diagnostic evaluation of syncope. J Am Soc Echocardiogr 11:294

    Article  PubMed  CAS  Google Scholar 

  • Parry SW, Richardson DA, O’Shea D et al (2000) Diagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential. Heart 83:22–23

    Article  PubMed  CAS  Google Scholar 

  • Pavlovic SU, Kocovic D, Djordjevic M et al (1991) The etiology of syncope in pacemaker patients. Pacing Clin Electrophysiol 14:2086–2091

    Article  PubMed  CAS  Google Scholar 

  • Pfisterer M, Heierli B, Burkart F (1979) Hypertensiver Karotissinusreflex bei älteren Patienten. Schweiz Med Wschr 107:1565–1570

    Google Scholar 

  • Raviele A, Brignole M, Sutton R et al (1999) Effect of etilefrine in preventing syncopal recurrence in patients with vasovagal syncope: a double-blind, randomized, placebo-controlled trial. The Vasovagal Syncope International Study. 99:1452–1457

    CAS  Google Scholar 

  • Sakaguchi S, Shultz JJ, Remole SC et al (1995) Syncope associated with exercise, a manifestation of neurally mediated syncope. Am J Cardiol 75:476–481

    Article  PubMed  CAS  Google Scholar 

  • Savage DD, Corwin L, McGee DL et al (1985) Epidemiologic features of isolated syncope: the Framingham Study. Stroke 16:626–629

    Article  PubMed  CAS  Google Scholar 

  • Scheinman MM; Peters RW, Sauvé MJ et al (1982) Value of HQ-interval in patients with bundle branch block and the role of prophylactic permanent pacing. Am J Cardiol 50:1316–1322

    Article  PubMed  CAS  Google Scholar 

  • Smit AA, Halliwill Jr, Low PA, Wieling W (1999) Pathophysiological basis of orthostatic hypotension in autonomie failure. J Physiol 519:1–10

    Article  PubMed  CAS  Google Scholar 

  • Smith GD, Mathias CJ (1995) Postural hypotension enhanced by exercise in patients with chronic heart failure. QJM 88:251–256

    PubMed  CAS  Google Scholar 

  • Sutton R, Peterson M, Brignole M et al (1992) Proposed classification for tilt induced vasovagal sincope. Eur J Cardiac Pacing Electrophysiol 3:180

    Google Scholar 

  • Telfer EA, Olashasky B (1998) Use of electrophysiological studies in syncope: Practical aspects for diagnosis and treatment. In Grubb BP, Olshansky B (eds) Synocpe: Mechanisms and management, p 179. Futura, Armonk NY

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Blum, T., Kalusche, D. (2004). Synkope. In: Roskamm, H., Neumann, FJ., Kalusche, D., Bestehorn, HP. (eds) Herzkrankheiten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18649-3_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18649-3_20

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62220-5

  • Online ISBN: 978-3-642-18649-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics