PT  - JOURNAL ARTICLE
AU  - James D. Maloney
AU  - Fredrick J. Jaeger
AU  - Fetnat M. Fouad-Tarazi
AU  - Harold H. Morris
TI  - Malignant vasovagal syncope: prolonged asystole provoked by head-up tilt
DP  - 1988 Nov 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 542--548
VI  - 55
IP  - 6
4099  - http://www.ccjm.org/content/55/6/542.short
4100  - http://www.ccjm.org/content/55/6/542.full
SO  - Cleve Clin J Med1988 Nov 01; 55
AB  - Vasovagal syncope is a common clinical disorder that often escapes diagnosis; if the syncope is recurrent and severe (malignant vasovagal syncope), it can be a source of morbidity and possibly mortality. The authors report a 39-year-old patient with recurrent, unexplained syncope who underwent provocative head-up tilt testing that resulted in asystole for 73 seconds. In addition to vasovagal syncope, head-up tilt test also aids in the diagnosis and management of disorders of blood pressure and heart rate regulation. Management of recurrent vasovagal syncope is based upon the underlying pathophysiology and includes transdermal scopolamine, volume expansion, biofeedback, support stockings, and pacemakers (preferably AV sequential).