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Schellong test in orthostatic dysregulation: a comparison with tilt-table testing.
Robert Winker1, Walter Prager, Arthur Haider
1Division of Occupational Medicine, Medical University of Vienna, Vienna, Austria. robert.winker@meduniwien.ac.at
Wiener Klinische Wochenschrift
|July 1, 2005
Summary
The Schellong test (ST) shows high specificity but low sensitivity for diagnosing postural orthostatic tachycardia syndrome (POTS) and neurocardiogenic syncope (NCS). It can be a first-line tool for orthostatic dysregulation, but the tilt-table test (TT) is essential if ST results are normal.
Area of Science:
- Cardiology
- Neurology
- Physiology
Background:
- Orthostatic dysregulation encompasses conditions like POTS and NCS.
- The tilt-table test (TT) is the gold standard for diagnosing these conditions.
- The Schellong test (ST) is a simpler, alternative diagnostic method.
Purpose of the Study:
- To compare the diagnostic accuracy of the ST against the TT for orthostatic dysregulation.
- To evaluate the ST's role in identifying POTS, NCS, and OH in young males.
Main Methods:
- 67 military recruits (mean age 22) underwent both ST and TT.
- Subjects were categorized based on TT results: normal, OH, POTS, or NCS.
- Chi-square analysis determined ST sensitivity and specificity compared to TT.
Main Results:
- TT identified 23 POTS, 16 NCS, and 2 OH cases.
- ST sensitivity for POTS was 61% (specificity 100%).
- ST sensitivity for NCS was 31% (specificity 100%).
- OH data was insufficient for analysis due to low case numbers.
Conclusions:
- The ST can serve as an initial diagnostic tool for orthostatic symptoms.
- A normal ST necessitates further evaluation with the TT due to its limited sensitivity for POTS and NCS.