Document Detail

Syncope in complex regional pain syndrome.
MedLine Citation:
PMID:  21462216     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Complex regional pain syndrome (CRPS) is a debilitating pain syndrome characterized clinically by severe pain along with signs and symptoms of autonomic dysfunction. Presyncope and syncope are common in these patients. The purpose of this study was to investigate the cause of these symptoms in these patients.
HYPOTHESIS: Patients with CRPS are more prone to presyncope and syncope as evidenced by head-up tilt table testing (HUTT).
METHODS: Patients with CRPS underwent a complete cardiac evaluation that included a 12-lead electrocardiogram, 2-dimensional echocardiography, 24-hour Holter monitoring, and HUTT.
RESULTS: Seventy-four patients with CRPS were evaluated. Eight CRPS patients (10%) could not complete a HUTT due to pain. Of the 66 CRPS patients who completed a HUTT, 15 (37.9%) reported pretest symptoms of presyncope or syncope. Twenty-eight CRPS patients (42.4%) had a positive HUTT. CRPS patients with lower limb involvement were more likely to have vasovagal syncope or orthostasis on HUTT than those with upper extremity or total body involvement (12 of 18 [67%] vs 16 of 48 [33%]; P = 0.015).
CONCLUSIONS: Syncope is common in patients with CRPS, especially with lower limb involvement. Autonomic dysregulation of the lower extremities leads to impaired sympathetic vasoconstriction and venous pooling, which can predispose these patients to syncope. Physician awareness of this syndrome will lead to improved recognition and treatment of their symptoms of presyncope or syncope. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose.
Jason A Smith; Dean G Karalis; Andrea L Rosso; John R Grothusen; Scott E Hessen; Robert J Schwartzman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  34     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Department of Cardiology, Drexel University College of Medicine, Philadelphia, Pennsylvania.
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