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Can prodromal symptoms predict recurrence of vasovagal syncope?
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Abstract
Methods: Seventy-nine consecutive patients (male/female: 53/26) with history of VVS and positive tilt table test (TTT) were enrolled in the study and completed the follow-up time for one year. They all had normal electrocardiograms and cardiac echocardiography without underlying disease. All of them were evaluated meticulously for prodromal symptoms (diaphoresis, nausea, palpitation and blurred vision) and frequency of syncopal spells in their past medical history. They received metoprolol at maximum tolerated dose and were taught tilt training as an empirical therapy after TTT.
Results: Fifty-four patients (68.4%) reported at least one of the four main prodromal symptoms. Median syncopal ± presyncopal spells were 4 episodes. Forty-two patients (53.2%) experienced recurrence of syncope or presyncope during the follow-up period. In recurrent symptomatic patients, diaphoresis had been more significantly reported in their past medical history (p = 0.018) and they had more syncopal spells before TTT (p = 0.001). Age, gender and type of TTT response did not have any effect on the recurrence of VVS.
Conclusions: Patients with a history of diaphoresis as a prodromal symptom and more pretilt syncopal attacks experience more syncopal or presyncopal spells during follow-up.
Abstract
Methods: Seventy-nine consecutive patients (male/female: 53/26) with history of VVS and positive tilt table test (TTT) were enrolled in the study and completed the follow-up time for one year. They all had normal electrocardiograms and cardiac echocardiography without underlying disease. All of them were evaluated meticulously for prodromal symptoms (diaphoresis, nausea, palpitation and blurred vision) and frequency of syncopal spells in their past medical history. They received metoprolol at maximum tolerated dose and were taught tilt training as an empirical therapy after TTT.
Results: Fifty-four patients (68.4%) reported at least one of the four main prodromal symptoms. Median syncopal ± presyncopal spells were 4 episodes. Forty-two patients (53.2%) experienced recurrence of syncope or presyncope during the follow-up period. In recurrent symptomatic patients, diaphoresis had been more significantly reported in their past medical history (p = 0.018) and they had more syncopal spells before TTT (p = 0.001). Age, gender and type of TTT response did not have any effect on the recurrence of VVS.
Conclusions: Patients with a history of diaphoresis as a prodromal symptom and more pretilt syncopal attacks experience more syncopal or presyncopal spells during follow-up.
Keywords
vasovagal syncope; prodromal symptoms; beta-blocker therapy
About this articleTitle
Can prodromal symptoms predict recurrence of vasovagal syncope?
Journal
Issue
Pages
446-450
Published online
2008-08-12
Page views
761
Article views/downloads
1192
DOI
10.5603/cj.21570
Bibliographic record
Cardiol J 2008;15(5):446-450.
Keywords
vasovagal syncope
prodromal symptoms
beta-blocker therapy
Authors
Amir Farjam Fazelifar
Hosein Ali Basiri
Ali Tolooie
Majid Haghjoo
Hamid Barakpour
Zahra Emkanjoo
Hooman Bakhshandeh Abkenar
Mahboubeh Zeighami
Foroozan Asgari
Mohammad Ali Sadr-Ameli
