Neuro Cardiogenic Syncope - Neuro Cardiogenic Syncope Information
Cardiogenic Syncope Information
Cardiogenic syncope can occur on a mechanical or arrhythmic basis. Mechanical problems that can cause syncope include aortic stenosis (where syncope may occur from autonomic reflex abnormalities or ventricular tachycardia), pulmonary stenosis, hypertrophic obstructive cardiomyopathy, congenital lesions associated with pulmonary hypertension or right-to-left shunting, and left atrial myxoma obstructing the mitral valve. Episodes are commonly exertional or postexertional. More commonly, cardiac syncope is due to disorders of automaticity (sick sinus syndrome), conduction disorders (atrioventricular block), or tachyarrhythmias (especially ventricular tachycardia and supraventricular tachycardia with rapid ventricular rate).
Neuro Cardiogenic Syncope Information
The evaluation for Neuro Cardiogenic Syncope depends on findings from the history and physical examination (especially orthostatic blood pressure evaluation, examination of carotid and other arteries, cardiac examination, and, if appropriate, carotid sinus massage). The resting ECG may reveal arrhythmias, evidence of accessory pathways, prolonged QT interval, and other signs of heart disease (such as infarction or hypertrophy). If the history is consistent with Neuro Cardiogenic Syncope, ambulatory electrocardiographic monitoring is essential. This may need to be repeated several times, since yields increase with longer periods of monitoring, at least up to 3 days. Event recorder and transtelephone electrocardiographic monitoring may be helpful in patients with intermittent presyncopal episodes. Electrophysiologic studies to assess sinus node function and atrioventricular conduction and to induce supraventricular or ventricular tachycardia are indicated in patients with recurrent episodes and nondiagnostic ambulatory ECGs. They reveal an arrhythmic cause in 20–50% of patients, depending on the study criteria, and are most often diagnostic when the patient has had multiple episodes and has identifiable cardiac abnormalities.