Dear Editor: Syncope is a serious problem with life-time prevalence of 35% (1). It is estimated that 1 -3% of referrals to emergency departments and in-patient admissions are due to syncope (2). The underlying conditions can be cardiac or neurologic. Considering the completely different circumstances ruling the encounters with cardiac and neurologic syncope, in recent years many attempts have b...

Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to have orthostatic, carotid sinus hypersensitivity, or cardiac syncope, whereas younger adults are more likely t...

BACKGROUND Syncope is a transient loss of consciousness, associated with loss of postural tone, with spontaneous return to baseline neurologic function. Syncope is a common complaint in the emergency department. OBJECTIVES Cough syncope occurs immediately after coughing. Cough syncope rapidly recovers in 1-2 second. Although cough syncope has been classified in vasovagal syncope, it may diffe...

BACKGROUND In syncope patients, presence of coronary artery disease (CAD) is associated with poor prognosis. However, data concerning CAD prevalence in syncope patients without known cardiovascular disease are lacking. Therefore, the aim of this study was to investigate presence and extent of CAD in syncope patients. METHODS We included 142 consecutive patients presenting with syncope at the ...

OBJECTIVES We studied the triggering mechanism for neurally mediated syncope. BACKGROUND Although increased transient sympathetic tone is thought to be necessary for the development of neurally mediated syncope, little is known about the triggering mechanism for neurally mediated syncope. METHODS Plasma epinephrine (EP) and norepinephrine (NE) levels were assessed in 20 syncope patients dur...

BACKGROUND Jugular venous reflux (JVR) has been reported to cause cough syncope via retrograde-transmitted venous hypertension and consequently decreased cerebral blood flow (CBF). Unmatched frequencies of JVR and cough syncope led us to postulate that there should be additional factors combined with JVR to exaggerate CBF decrement during cough, leading to syncope. The present pilot study teste...

Sleep syncope is a recently described form of vasovagal syncope that interrupts sleep. The pathophysiology of this condition is uncertain but a 'central' non-baroreflex-mediated trigger has been suggested. In the present study, we tested the hypothesis that patients with sleep syncope have abnormal sympatho-vagal responses to non-baroreflex, but normal responses to baroreflex stimuli. We collec...

Carotid body tumor (CBT) is paraganglioma and mainly found in the carotid bifurcation. The manifestations of the tumor are variable; in most cases, it presents as a non-symptomatic slow-growing mass, rarely compression of carotid body induces bradycardia and hypotension and repeated syncope, prolonged syncope can cause convulsion. Convulsive syncope occurred in 0.03% of patients with syncope. I...

sublingual nitroglycerin (tng) has been introduced as a promising provocative agent for tilt table testing, but it has not been compared directly with the standard isoproterenol (iso) infusion test previously. we tried to assess the diagnostic value and safety of tng tilt testing as compared with iso infusion in patients with unexplained syncope. tng and iso tilt tests were performed in two suc...

pulmonary thromboembolism (pte) has a wide spectrum of presentations, and its c ardinal manifestations include chest pain, dyspnea, and syncope. syncope as an initial presentation of pte occurs in 10-14% of patients and is not restricted to massive ptes. it can also occur in the setting of non- massive cases probably due to a vasovagal mechanism or the occurrence of conduction disturbances in p...