Skip to main content

Syncope with Exercise: Mechanisms and Management

  • Conference paper
Cardiac Arrhythmias 2001
  • 74 Accesses

Zusammenfassung

Syncope associated with exercise is infrequent but warrants special consideration, both because of the adverse prognostic implications in certain situations, and because of the community concern that often arises when these events occur in otherwise healthy active individuals such as student athletes or prominent professionals.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
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

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Yerg JE II, Seals DR, Hagberg JM, Ehsani AA (1986) Syncope secondary to ventricular asystole in an endurance athlete. Clin Cardiol 9:220–222

    Article  PubMed  Google Scholar 

  2. Huycke EC, Card HG, Sobol SM et al (1987) Postexertional cardiac asystole in a young man without organic heart disease. Ann Intern Med 106:844–845

    Article  CAS  PubMed  Google Scholar 

  3. Greci ED, Ramsdale DR (1991) Exertional syncope in aortic stenosis: evidence to support inappropriate left ventricular baroreceptor response. Am Heart J 121:603–606

    Article  Google Scholar 

  4. Arad M, Solomon A, Roth A et al (1993) Postexercise syncope: evidence for increased activity of the sympathetic nervous system. Cardiology 83:121–123

    Article  CAS  PubMed  Google Scholar 

  5. Osswald S, Brooks R, O’Nunain SS et al (1994) Asystole after exercise in healthy persons. Ann Intern Med 120:1008–1011

    Article  CAS  PubMed  Google Scholar 

  6. O’Connor FG, Oriscello RG, Levine BD (1999) Exercise-related syncope in the young athlete: Reassurance, restriction or referral? Am Fam Phys 60:2001–2008

    Google Scholar 

  7. Sneddon JF, Scalia G, Ward DE et al (1994) Exercise induced vasodepressor syncope. Br Heart J 71:554–557

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. 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  CAS  PubMed  Google Scholar 

  9. Calkins H, Seifert M, Morady F (1995) Clinical presentation and long-term follow-up of athletes with exercise-induced vasodepressor syncope. Am Heart J 129:1159–1164

    Article  CAS  PubMed  Google Scholar 

  10. Tse HF, Lau P (1995) Exercise-associated cardiac asystole in persons without structural heart disease. Chest 107:572–576

    Article  CAS  PubMed  Google Scholar 

  11. Abe H, Nakashima Y, Kohshi K, Kuroiwa A (1997) Exercise-induced neurally mediated syncope. Jpn Heart J 38:535–539

    Article  CAS  PubMed  Google Scholar 

  12. Smith GPD, Mathias CJ (1995) Postural hypotension enhanced by exercise in patients with chronic autonomic failure. Q J Med 88:251–256

    CAS  Google Scholar 

  13. Hainsworth R (1999) Syncope and fainting: classification and pathophysiological basis. In: Mathias CJ, Bannister R (eds) Autonomic failure: a textbook of clinical disorders of the autonomic nervous system, 4th edn. Oxford University Press, Oxford, pp 428–436

    Google Scholar 

  14. Benditt DG, Milstein S, Goldstein MA et al (1990) Sinus node dysfunction: pathophysiology, clinical features, evaluation and treatment. In: Zipes DP, Jalife J (eds) Cardiac electrophysiology: from cell to bedside. Saunders, Philadelphia, pp 708–734

    Google Scholar 

  15. Pathy MS (1967) Clinical presentation of myocardial infarction in the elderly. Br Heart J 29:190–199

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Kovac JD, Murgatroyd 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  CAS  PubMed  Google Scholar 

  17. Ascheim DD, Markowitz SM, Lai H et al (1997) Vasodepressor syncope due to subclinical myocardial ischemia. J Cardiovasc Electrophysiol 8:215–221

    Article  CAS  PubMed  Google Scholar 

  18. Havranek EP, Dunbar DN (1992) Exertional syncope caused by left main coronary artery spasm. Am Heart J 123:792–794

    Article  CAS  PubMed  Google Scholar 

  19. Hattori R, Murohara Y, Yui Y et al (1987) Diffuse triple-vessel coronary artery spasm complicated by idioventricular rhythm and syncope. Chest 92:183–185

    Article  CAS  PubMed  Google Scholar 

  20. Watanabe K, Inomata T, Miyakita Y et al (1993) Electrophysiologic study and ergono-vine provocation of coronary spasm in unexplained syncope. Jpn Heart J 34:171–182

    Article  CAS  PubMed  Google Scholar 

  21. Romeo F, Cianfrocca C, Pelliccia F et al (1990) Long-term prognosis in children with hypertrophic cardiomyopathy: an analysis of 37 patients aged < 14 years at diagnosis. Clin Cardiol 13:101

    Article  CAS  PubMed  Google Scholar 

  22. McKenna WJ, Deanfield J, Faruqui A et al (1981) Prognosis in hypertrophic cardiomyopathy: role of age and clinical electrocardiographic and hemodynamic features. Am J Cardiol 47:532–538

    Article  CAS  PubMed  Google Scholar 

  23. Shapira Y, Kusniec J, Birnbaum Y, Strasberg B (1996) Exercise-induced syncope and Holter-documented asystole in an endurance runner with moderate aortic stenosis. Clin Cardiol 19:71–73

    Article  CAS  PubMed  Google Scholar 

  24. Chamarthi B, Dubrey SW, Cha K et al (1997) Features and prognosis of exertional syncope in light-chain associated AL cardiac amyloidosis. Am J Cardiol 80:1242–1245

    Article  CAS  PubMed  Google Scholar 

  25. Atwood JE, Kawanishi S, Myers J, Froelicher VF (1988) Exercise testing in patients with aortic stenosis. Chest 93:1083–1087

    Article  CAS  PubMed  Google Scholar 

  26. Sneddon JF, Slade A, Seo H et al (1997) Assessment of the diagnostic value of head-up tilt testing in the evaluation of syncope in hypertrophic cardiomyopathy. Am J Cardiol 80:1242–1245

    Article  Google Scholar 

  27. Dhingra RC, Amat-y-Leon F et al (1976) Infranodal block: diagnosis, clinical significance and management. Med Clin North Am 60:175–192

    CAS  PubMed  Google Scholar 

  28. Byrne JM, Marais H J, Cheek G A (1994) Exercise-induced complete heart block in a patient with chronic bifascicular block. J Electrocardiol 27:339–342

    Article  CAS  PubMed  Google Scholar 

  29. Woeifel AK, Simpson RJ, Gettes LS, Foster JR (1983) exercise-induced distal atrioventricular block. J Am Coll Cardiol 2:578–582

    Article  Google Scholar 

  30. Barra M, Brignole M, Menozzi CA et al (1985) An exercise induced intermittent atrio-ventricular block. Report of three cases report (in Italian). G Ital Cardiol 15:1051–1055

    CAS  PubMed  Google Scholar 

  31. Yuzuki Y, Horie M, Makita T et al (1997) Exercise-induced second-degree atrioventricular block. Jpn Cire J 61:268–271

    Article  CAS  Google Scholar 

  32. Leitch JW, Klein GJ, Yee R et al (1992) Syncope associated with supraventricular tachycardia: an expression of tachycardia or vasomotor response. Circulation 85:1064–1071

    Article  CAS  PubMed  Google Scholar 

  33. Camm AJ, Lau CP (1988) Syncope of undetermined origin: diagnosis and management. Prog Cardiol 1:139–156

    Google Scholar 

  34. Dhingra RC, Denes P, Wu D et al (1974) Syncope in patients with chronic bifascicular block. Significance, causative mechanisms, and clinical implications. Ann Int Med 81:302–306

    Article  CAS  PubMed  Google Scholar 

  35. Middelkauff HR, Stevenson WG, Stevenson LW, Saxon LA (1993) Syncope in advanced heart failure: high risk of sudden death regardless of origin of syncope. J Am Coll Cardiol 21:110–116

    Article  Google Scholar 

  36. Morady F, Shen E, Schwartz A et al (1983) Long-term follow-up of patients with recurrent unexplained syncope evaluated by electrophysiologic testing. J Am Coll Cardiol 2:1053–1059

    Article  CAS  PubMed  Google Scholar 

  37. Jackman WM, Friday KJ, Anderson JL et al (1988) The long QT syndromes: a critical review, new clinical observations and a unifying hypothesis. Prog Cardiovasc Dis 31:115–172

    Article  CAS  PubMed  Google Scholar 

  38. Moss AJ, Schwartz PJ, Crampton RS et al (1991) The long QT syndrome: prospective longitudinal study of 328 families. Circulation 84:1136–1144

    Article  CAS  PubMed  Google Scholar 

  39. Schwartz PJ, Zaza A, Locati E, Moss AJ (1991) Stress and sudden death. The case of the long QT syndrome. Circulation 83(Suppl II):71–80

    Google Scholar 

  40. Kosinski D, Grubb BP, Kip K, Hahn H (1996) Exercise-induced neurocardiogenic syncope. Am Heart J 132:451–452

    Article  CAS  PubMed  Google Scholar 

  41. Thomson HL, Atherton J J, Khafagi FA, Frenneaux MP (1996) Failure to reflex venocon-striction during exercise in patients with vasovagal syncope. Circulation 93:953–959

    Article  CAS  PubMed  Google Scholar 

  42. Kapoor W (1990) Evaluation and outcome of patients with syncope. Medicine 69:160–175

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag Italia

About this paper

Cite this paper

Benditt, D.G. (2002). Syncope with Exercise: Mechanisms and Management. In: Raviele, A. (eds) Cardiac Arrhythmias 2001. Springer, Milano. https://doi.org/10.1007/978-88-470-2103-7_6

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2103-7_6

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2165-5

  • Online ISBN: 978-88-470-2103-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics