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Related Experiment Videos

Psychogenic syncope diagnosed by prolonged head-up tilt testing

M E Petersen1, T R Williams, R Sutton

  • 1Department of Cardiology, Chelsea and Westminster Hospital, London, UK.

QJM : Monthly Journal of the Association of Physicians
|March 1, 1995
PubMed
Summary

This study describes four female patients experiencing syncope during head-up tilt testing. The findings suggest a psychogenic cause for recurrent syncope in these younger, symptomatic individuals.

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Area of Science:

  • Cardiology
  • Neurology
  • Psychiatry

Background:

  • Unexplained syncope is a common clinical problem.
  • Head-up tilt testing (HUTT) is a diagnostic tool for syncope.
  • Identifying the cause of syncope is crucial for patient management.

Observation:

  • Four patients presented with syncope during prolonged HUTT.
  • These patients had normal blood pressure and heart rate responses.
  • They were younger, more symptomatic, and predominantly female compared to other syncope groups.

Findings:

  • The observed syncope episodes during HUTT were similar to spontaneous events.
  • These cases constituted 5.5% of positive HUTT outcomes in a prospective study.
  • The tilt response in these patients is suggested to be psychogenic.

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Implications:

  • Psychogenic syncope may be an underdiagnosed cause of recurrent fainting.
  • Psychiatric evaluation may be beneficial for select patients with unexplained syncope.
  • This highlights the importance of considering psychological factors in syncope diagnosis.