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Intravenous cannulation alters the specificity of head-up tilt testing for vasovagal syncope in elderly patients
S J McIntosh1, J Lawson, R A Kenny
1Department of Medicine/Geriatric Medicine, Royal Victoria Infirmary, Newcastle upon Tyne.
Prolonged head-up tilt is increasingly used as a diagnostic test for vasovagal syncope. Its sensitivity is reported to increase with the concurrent administration of intravenous isoprenaline. False-positive responses are common in young controls particularly following intravascular instrumentation. We studied the influence of intravenous cannulation alone on responses to head-up tilt in ten healthy elderly subjects. All remained asymptomatic during tilt when non-cannulated whilst five developed symptomatic hypotension following cannulation. Thus, intravascular instrumentation influences responses to held-up tilt in elderly subjects; the significance of positive responses obtained using intravenous isoprenaline in this age group requires further evaluation.
Prolonged head-up tilt is increasingly used as a diagnostic test for vasovagal syncope. Its sensitivity is reported to increase with the concurrent administration of intravenous isoprenaline. False-positive responses are common in young controls particularly following intravascular instrumentation. We studied the influence of intravenous cannulation alone on responses to head-up tilt in ten healthy elderly subjects. All remained asymptomatic during tilt when non-cannulated whilst five developed symptomatic hypotension following cannulation. Thus, intravascular instrumentation influences responses to held-up tilt in elderly subjects; the significance of positive responses obtained using intravenous isoprenaline in this age group requires further evaluation.