RT Journal Article
SR Electronic
T1 Malignant vasovagal syncope: prolonged asystole provoked by head-up tilt
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 542
OP 548
VO 55
IS 6
A1 James D. Maloney
A1 Fredrick J. Jaeger
A1 Fetnat M. Fouad-Tarazi
A1 Harold H. Morris
YR 1988
UL http://www.ccjm.org/content/55/6/542.abstract
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).