Document Detail


A study of carotid sinus massage and head-up tilt table testing in patients with syncope and near-syncope.
MedLine Citation:
PMID:  12147883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with syncope of unknown origin are commonly evaluated using several diagnostic tools. It has been suggested that there is a significant overlap between the results of head-up tilt table testing (HUT) and carotid sinus massage (CSM). We retrospectively studied the association between tilt table test results and CSM outcome in 136 patients with syncope or near-syncope who underwent both tests. Carotid sinus massage was performed prior to the tilt test, with the patient supine. The patient was then tilted to 60 degrees for up to 30 minutes. If this did not elicit a symptomatic abnormal hemodynamic response, the tilt was repeated for up to 30 minutes with intravenous isoproterenol. An abnormal response on HUT was elicited in 18% of patients and carotid sinus syndrome was diagnosed in 13%. Mild carotid sinus sensitivity was seen in 14%. Both tests were positive in 4 patients (3%; 11% of patients with a positive test). There was no significant relationship between HUT outcome and CSM result (p = 0.03). Patients with an abnormal CSM result were older (p < 0.001) and more likely to have prior cardiovascular diagnoses (p = 0.01). The opposite applied to patients with abnormal HUT (p = 0.02 and p = 0.0048, respectively). In conclusion, we did not find a concordance between HUT and CSM outcomes in patients with syncope or near-syncope of undetermined origin.
Authors:
Friederike von zur Muhlen; Weilun Quan; David J D'Agate; Todd J Cohen
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  14     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-30     Completed Date:  2002-09-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  477-82     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Winthrop-University Hospital, Mineola, New York 11501, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cardiovascular Diseases / complications,  diagnosis
Carotid Sinus / surgery*
Female
Heart Massage*
Humans
Male
Middle Aged
New York
Recurrence
Sensitivity and Specificity
Severity of Illness Index
Sex Factors
Syncope / complications,  diagnosis*,  therapy*
Syndrome
Tilt-Table Test*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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