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Journal of Internal Medicine Sep 1997Pheochromocytoma endures as a life-threatening disorder. In the absence of systemic hypertension, diagnosis may be difficult. We present a 46-year-old normotensive male...
Pheochromocytoma endures as a life-threatening disorder. In the absence of systemic hypertension, diagnosis may be difficult. We present a 46-year-old normotensive male with a history of presyncope. One of these episodes could be documented, and revealed symptomatic bradycardia suspicious of sinus node arrest. Due to hints of an elevated sympathetic tone (Schellong test, circadian blood pressure pattern without diurnal rhythm) 24-h urinary catecholamine concentrations were measured and found increased. MIBG-scintigraphy and abdominal-computed tomography indicated the location of the pheochromocytoma. After removal of the tumour, no further episodes of presyncopes or bradydysrhythmias were observed.
Topics: Adrenal Gland Neoplasms; Bradycardia; Cysts; Diagnosis, Differential; Humans; Male; Middle Aged; Pheochromocytoma; Syncope
PubMed: 9350170
DOI: 10.1046/j.1365-2796.1997.00198.x -
Chinese Medical Journal 2014
Topics: Humans; Pediatrics; Syncope
PubMed: 25382318
DOI: No ID Found -
Archives of Internal Medicine Nov 1990The purpose of this study was to determine whether syncope and presyncope were associated with drug therapy in 70 patients referred to a tertiary care ambulatory clinic.... (Clinical Trial)
Clinical Trial Comparative Study
The purpose of this study was to determine whether syncope and presyncope were associated with drug therapy in 70 patients referred to a tertiary care ambulatory clinic. Drug use information was obtained, validated, and classified by its potential to cause syncope and presyncope. Utilizing a standardized adverse drug reaction algorithm, nine (13%) of the 70 patients were rated as having probable drug-induced syncope and presyncope events. Overall, 12 medications were implicated. Patients with probable adverse drug reactions were older, and taking more medications, or taking an antihypertensive. Seven of the nine patients with probable adverse drug reactions were previously classified as having syncope of unknown origin after their initial clinic evaluation. Syncope and presyncope are commonly associated with adverse drug reactions, especially in the elderly and those taking multiple medications.
Topics: Accidental Falls; Age Factors; Algorithms; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Middle Aged; Outpatient Clinics, Hospital; Referral and Consultation; Syncope
PubMed: 2241439
DOI: No ID Found -
Europace : European Pacing,... Nov 2020
Topics: Bradycardia; Electrocardiography; Humans; Recurrence; Syncope
PubMed: 33057604
DOI: 10.1093/europace/euaa197 -
Lancet (London, England) Jun 2001
Topics: Humans; Recurrence; Syncope
PubMed: 11407386
DOI: 10.1016/S0140-6736(00)04916-3 -
Primary Care Jun 2015Patients presenting to primary care with complaints of dizziness are common. Differentiating the cause of dizziness can be made easier by considering 4 main categories... (Review)
Review
Patients presenting to primary care with complaints of dizziness are common. Differentiating the cause of dizziness can be made easier by considering 4 main categories of dizziness: vertigo, presyncope/syncope, disequilibrium, and nonspecific symptoms. Differentials should immediately include the most common causes of dizziness, such as benign paroxysmal positional vertigo and orthostatic hypotension. Diagnostic tests should be ordered for patients who have abnormal findings on physical examination that may indicate a more serious cause of dizziness.
Topics: Diagnosis, Differential; Dizziness; Humans; Physical Examination; Primary Health Care; Syncope; Vertigo
PubMed: 25979586
DOI: 10.1016/j.pop.2015.01.004 -
The Nurse Practitioner Dec 2012Dizziness is a general term used to express subjective patient complaints related to changes in sensation, movement, perception, or consciousness. There are four types...
Dizziness is a general term used to express subjective patient complaints related to changes in sensation, movement, perception, or consciousness. There are four types of dizziness: vertigo, disequilibrium, presyncope/syncope, and dizziness as a result of psychological disturbances. Differentiating the type of dizziness will assist in the course of the evaluation.
Topics: Diagnosis, Differential; Dizziness; Humans; Nursing Assessment; Syncope; Vertigo
PubMed: 23165136
DOI: 10.1097/01.NPR.0000422206.92550.5b -
Clinical Physiology (Oxford, England) May 1992The mechanism(s) responsible for the onset of presyncope during a central hypovolaemic challenge have gone undefined for many years. It has been speculated that a...
The mechanism(s) responsible for the onset of presyncope during a central hypovolaemic challenge have gone undefined for many years. It has been speculated that a decrease in cerebral blood flow initiates presyncopal responses, which in turn lead to greater decreases in cerebral oxygen delivery and unconsciousness. Somatosensory evoked potentials (SEP) were monitored as a measure of cerebral functioning in ten subjects during presyncopal symptom limiting lower body negative pressure (a central hypovolaemic challenge). SEP latency and amplitudes have been correlated with cerebral oxygen uptake, so SEP activity can serve as an indirect indicator of cerebral homeostasis. SEPs were generated by electrically stimulating the median nerve and recoding the resulting potentials over the contralateral cerebral cortex. While heart rate and mean blood pressure both fell at presyncope, there were no changes noted in either SEP latency or amplitude at any point before (latency = 22.9 +/- 9 ms; amplitude = 2.86 +/- 0.24 microV), during (22.6 +/- 0.9 ms; 2.68 +/- 0.2 microV), or after (22.7 +/- 0.9 ms; 2.37 +/- 0.23 microV) the occurrence of presyncope. We conclude that the onset of presyncope is not associated with a decrease in cerebral function.
Topics: Adult; Blood Pressure; Blood Volume; Brain; Cerebral Cortex; Cerebrovascular Circulation; Evoked Potentials, Somatosensory; Female; Heart Rate; Humans; Lower Body Negative Pressure; Male; Oxygen Consumption; Syncope
PubMed: 1606810
DOI: 10.1111/j.1475-097x.1992.tb00832.x -
Epileptic Disorders : International... Dec 2007
Topics: Diagnosis, Differential; Epilepsy; Humans; Syncope
PubMed: 18077228
DOI: 10.1684/epd.2007.0134 -
Journal of Cardiovascular... Aug 2009Vasovagal syncope is common and distressing. One important symptom is presyncope, but there are no clinimetric measures of this. We developed the Calgary Presyncope Form... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
Vasovagal syncope is common and distressing. One important symptom is presyncope, but there are no clinimetric measures of this. We developed the Calgary Presyncope Form (CPF) and used it to test whether metoprolol reduces presyncope in a randomized trial.
METHODS
The CPF captures the frequency, duration, and severity of presyncope. We administered it to participants in the Prevention of Syncope Trial (POST), a randomized clinical trial that tested the hypothesis that metoprolol reduces syncope and presyncope in adult patients with vasovagal syncope.
RESULTS
The CPF was completed by 44 patients on metoprolol and 39 patients on placebo, of a total of 208 subjects. Completion of the CPF for each of the threedimensions was 84-87% in the 83 respondents. Results were centrally distributed in duration and severity dimensions, but not in frequency. Patients had a median of 1.2 presyncopal spells per day, with a median moderate severity, lasting a median 10 minutes. The 3 scales were statistically independent of each other. These results were independent of subject age, and results in all 3 dimensions were stable over the observation period. There was no significant difference between patients on metoprolol and placebo in any dimension.
CONCLUSION
The 3-dimensional CPF is simple, easy to use, stable over time, measures 3 independent variables, and documents that metoprolol does not reduce presyncope.
Topics: Adult; Double-Blind Method; Evaluation Studies as Topic; Female; Follow-Up Studies; Humans; Male; Metoprolol; Middle Aged; Research Design; Severity of Illness Index; Syncope; Weights and Measures; Young Adult
PubMed: 19368584
DOI: 10.1111/j.1540-8167.2009.01466.x