#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Commented shortened version of the 2018 ESC Guidelines for the diagnosis and management of syncope


Authors: P. Heinc;  K. Vykoupil;  R. Nykl;  Š. Hudec;  R. Aiglová;  L. Rec
Authors place of work: I. interní klinika –  kardiologická, Fakultní nemocnice Olomouc
Published in the journal: Kardiol Rev Int Med 2018, 20(3): 197-207

Summary

New European Guidelines for the diagnosis and management of syncope have been issued to provide a consistent and systematic approach to patients with a temporary loss of consciousness. This article summarises and comments upon the classification, diagnostic, therapeutic and organisational rules for the healthcare provided to these patients. The shortened and commented version of the new recommendations is intended to provide greater clarity for practical use.

Key words:

syncope – classification – diagnostic principles – risk stratification – treatment – healthcare organisation


Zdroje

1. Brignole M, Moya A, de Lange FJ et al. 2018 ESC Guidelines for the dia­gnosis and management of syncope. Eur Heart J 2018; 39(21): 1883–1948. doi: 10.1093/eurheartj/ehy037.

2. Brignole M, Moya A, de Lange FJ et al. Practical Instructions for the 2018 ESC Guidelines for the dia­gnosis and management of syncope. Eur Heart J 2018: 39(21): e43–e80. doi: 10.1093/eurheartj/ehy071.

3. Mosqueda-Garcia R, Furlan R, Tank J et al. The elusive pathophysiology of neural­ly mediated syncope. Circulation 2000; 102(23): 2898–2906.

4. Moril­lo CA, Eckberg DL, El­lenbogen KA et al. Vagal and sympathetic mechanisms in patients with orthostatic vasovagal syncope. Circulation 1997; 96(8): 2509–2513.

5. Alboni P, Furlan R. Vasovagal syncope. Heidelberg: Springer 2015: 3–17.

6. Freeman R, Wiel­­ing W, Axelrod FB et al. Consensus statement on the definition of orthostatic hypotension, neural­ly mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011; 21(2): 69–72. doi: 10.1007/s10286-011-0119-5.

7. Fedorowski A, Melander O. Syndromes of orthostatic intolerance: a hidden danger. J Intern Med 2013; 273(4): 322–335. doi: 10.1111/joim.12021.

8. Palma JA, Gomez-Esteban JC, Norclif­fe-Kaufmann Let al. Orthostatic hypotension in Parkinson dis­ease: how much you fall or how low you go? Mov Disord 2015; 30(5): 639–645. doi: 10.1002/mds.26079.

9. Lagro J, Schoon Y, Heerts I et al. Impaired systolic blood pres­sure recovery directly after stand­­ing predicts mortality in older fal­ls clinic patients. J Gerontol A Biol Sci Med Sci 2014; 69(4): 471–478. doi: 10.1093/gerona/glt111.

10. Fedorowski A, Li H, Yu X et al. Antiadrenergic autoim­munity in postural tachycardia syndrome. Europace 2017; 19(7): 1211–1219. doi: 10.1093/europace/euw154.

11. van Dijk JG, Thijs RD, Benditt DG et al. A guide to disorders caus­­ing transient loss of consciousnes­s: focus on syncope. Nat Rev Neurol 2009; 5(8): 438–448. doi: 10.1038/nrneurol.2009.99.

12. Kel­ler K, Beule J, Balzer JO et al. Syncope and col­lapse in acute pulmonary embolism. Am J Emerg Med 2016; 34(7): 1251–1257. doi: 10.1016/j.ajem.2016.03.061.

13. Wiel­­ing W, Thijs RD, van Dijk N et al. Symp­toms and signs of syncope: a review of the link between physiology and clinical clues. Brain 2009; 132(Pt 10): 2630–2642. doi: 10.1093/brain/awp179.

14. Moya A, Permanyer-Miralda G, Sagrista-Sauleda Jet al. Limitations of head-up tilt test for evaluat­­ing the ef­ficacy of therapeutic interventions in patients with vasovagal syncope: results of a control­led study of etilefrine versus placebo. J Am Coll Cardiol 1995; 25(1): 65–69.

15. Flam­mang D, Church TR, De Roy L et al. ATP Multicenter Study. Treatment of unexplained syncope: a multicenter, randomized trial of cardiac pac­­ing guided by adenosine 5’-triphosphate testing. Circulation 2012; 125(1): 31–36. doi: 10.1161/CIRCULATIONAHA.111.022855.

16. Bass EB, Curtiss EI, Arena VC et al. The duration of Holter monitor­­ing in patients with syncope. Is 24 hours enough? Arch Intern Med 1990; 150(5): 1073–1078.

17. LaFrance WC Jr, Baker GA, Duncan R et al. Minimum requirements for the dia­gnosis of psychogenic nonepileptic seizures: a staged approach: a report from the International League Against Epilepsy Nonepileptic Seizures Task Force. Epilepsia 2013; 54(11): 2005–2018. doi: 10.1111/epi.12356.

18. Tan­nemaat MR, van Niekerk J, Reijntjes RH et al. The semiology of tilt-induced psychogenic pseudosyncope. Neurology 2013; 81(8): 752–758. doi: 10.1212/WNL.0b013e3182a1aa88.

19. Brignole M, Menozzi C, Bartoletti A et al. A new management of syncope: prospective systematic guideline-based evaluation of patients refer­red urgently to general hospitals. Eur Heart J 2006; 27(1): 76–82. doi: 10.1093/eurheartj/ehi647

20. Sarasin FP, Junod AF, Carbal­lo D et al. Role of echocardiography in the evaluation of syncope: a prospective study. Heart 2002; 88(4): 363–367.

21. Ken­ny RA, Brignole M, Dan GA et al. Syncope Unit: rationale and requirement – the European Heart Rhythm As­sociation position statement endorsed by the Heart Rhythm Society. Europace 2015; 17(9): 1325–1340. doi: 10.1093/europace/euv115.

22. Verheyden B, Liu J, van Dijk N et al. Steep fall in cardiac output is main determinant of hypotension dur­­ing drug-free and nitroglycerine-induced orthostatic vasovagal syncope. Heart Rhythm 2008; 5(12): 1695–1701. doi: 10.1016/j.hrthm.2008.09.003.

Štítky
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#