González-Duarte A, Estañol-Vidal B, Oseguera-Moguel J

Language: Spanish
References: 9
Page: 30-35
PDF size: 270.77 Kb.

ABSTRACT

The presence of recurrent syncope, or a single syncope in a high-risk patient without evidence of structural heart disease, or even with a previously recognized heart condition that does not explain the event, are circumstances that require an evaluation of the autonomic nervous system in order to provide a precise diagnosis and to define a treatment plan. The goal of such evaluation is not to reproduce the syncope or associated symptoms, but to describe the type of autonomic response that generates the test. The stereotyped autonomic responses or hemodynamic patterns help to establish the syncope etiology. Of great importance is to investigate the presence of cardiologic abnormalities and, in case of their existence, it is necessary to refer the patient with a specialist as soon as possible. Orthostatic hypotension, postural orthostatic tachycardia syndrome (POTS) and neurogenic syncope are the three main groups recognized as syncope varieties. It is not the main goal of therapy to achieve normotension, but to improve postural symptoms, the time of orthostatic tolerance, and the performance of daily activities without syncope. Of vital importance is to avoid producing supine hypertension with treatment. Drug therapy is never adequate by itself and the strategy should vary depending on the orthostatic stress

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