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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
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Syncope while driving: pathophysiological features and long-term follow-up.

Antonio Franco Folino1, Federico Migliore, Alberto Porta

  • 1Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Italy. franco.folino@unipd.it

Autonomic Neuroscience : Basic & Clinical
|October 18, 2011
PubMed
Summary
This summary is machine-generated.

Syncope while driving is often linked to hypertension and vasodepressive reactions. Patients have a good prognosis, but risk stratification is crucial for those over 50 with recurrent episodes.

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Area of Science:

  • Cardiology
  • Neurology
  • Emergency Medicine

Background:

  • Syncope (fainting) occurs in 3-10% of patients while driving.
  • Understanding clinical and pathophysiological features is key for managing driving syncope.

Purpose of the Study:

  • To identify clinical and pathophysiological features of syncope while driving.
  • To estimate syncope recurrence incidence and correlate features with recurrence.

Main Methods:

  • Prospective study of 40 driving syncope patients and 50 non-driving syncope patients.
  • Upright tilt test (UTT) with ECG and blood pressure monitoring to assess heart rate variability, total peripheral resistance (TPR), and stroke volume (SV).

Main Results:

  • Driving syncope patients had higher rates of hypertension (40% vs 20%) and vasodepressive reactions (52% vs 26%) during UTT.
  • Increased heart rates and lower SVs were observed in driving syncope patients during UTT.
  • Recurrences (20%) occurred in 8 driving syncope patients, but never while driving; they were older with more episodes and vasodepressive reactions.

Conclusions:

  • Syncope while driving generally has a good prognosis.
  • Risk stratification is essential for patients over 50 with >4 syncope episodes and vasodepressive reactions.