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[Tilt-table test in the diagnosis of syncope of unknown origin]
1Division of Cardiology, Medical College of Pennsylvania.
Abstract:
71 patients with unexplained syncope was examined by 60 grade of head up tilt table test with or without administration of isoproterenol during 25 minutes interval. The mean age of patients was 71.44 +/- 16.40 (12-86) years. 38 (54%) were female and 33 (46%) were male. The underlying heart disease were 27 (38%) coronary artery disease, 12 (17%) arterial hypertension, 6 (8%) diabetes mellitus, 3 (4%) valvular heart disease and 14 (20%) patients had other diseases. Nine (13%) patients had no organic disease. During head up tilt table test positive reaction was found in 13 (18%) patients. Four (6%) patients were vaso-vagal syncope with classic signs, and 9 (13%) patients were vasodepressor type of syncope, without changes in the heart rate. Isoproterenol was given to 16 (23%) patients, and in 4 (6%) (2 vasodepressor and 2 mixed type of syncope) patients occurred the positive test during isoproterenol administration. Orthostatic reaction occurred during head up tilt table test in 14 (20%) patients. Normal was the result of tilt table test in 42 (59%) patients, and two (3%) patients had autonome neuropathy. The vasovagal syncope was treated by metoprolol, atenolol and disopyramid with success. The head up tilt table testing is a good, simple, useful test for evaluation of syncope patients, especially the diagnosis of vasovagal syndrome.