Dysautonomia and neurocardiogenic syncope

Authors
Citation
Ka. Mcleod, Dysautonomia and neurocardiogenic syncope, CURR OPIN C, 16(2), 2001, pp. 92-96
Citations number
19
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
CURRENT OPINION IN CARDIOLOGY
ISSN journal
0268-4705 → ACNP
Volume
16
Issue
2
Year of publication
2001
Pages
92 - 96
Database
ISI
SICI code
0268-4705(200103)16:2<92:DANS>2.0.ZU;2-3
Abstract
Syncope in childhood is a common problem. In most children, syncope is beni gn, secondary to a disturbance in autonomic control of heart rate and blood pressure. It is increasingly evident that neurally mediated syncope is a h eterogeneous group of conditions, necessitating a reclassification of auton omic disorders. New entities, such as postural orthostatic tachycardia and cerebral vasoconstrictive syncope, are recognized. The key to the diagnosis of syncope is a careful history. Tilt testing can be useful when the histo ry is unclear. Unfortunately tilt test protocols vary, affecting specificit y and sensitivity. The mainstay of therapy is reassurance. if symptoms are troublesome, Fludrocortisone and B-blockers remain the favored drugs. The e fficacy of Midodrine and Serotonin Uptake Inhibitors is currently under rev iew. Cardiac pacing is effective for those patients with severe episodes an d demonstrated asystole. It is not known whether pacing would be effective for the majority who have neurally mediated syncope without significant bra dycardia. Curr Opin Cardiol 2001, 16:92-96 (C) 2001 Lippincott Williams & W ilkins, Inc.