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  • Title: Clinical characteristics of patients with vasovagal reactions presenting as unexplained syncope.
    Author: Graham LA, Kenny RA.
    Journal: Europace; 2001 Apr; 3(2):141-6. PubMed ID: 11333052.
    Abstract:
    OBJECTIVE: To describe the clinical characteristics of vasovagal syncope (VVS) in patients presenting to a tertiary referral centre with unexplained syncope, in whom the diagnosis of VVS was confirmed by tilt table testing (HUT) and in whom other causes of syncope excluded. DESIGN: Prospective study of 62 consecutive patients with more than two episodes of syncope in the past year. SETTING: A regional tertiary referral centre for patients with unexplained syncope. PATIENTS: Sixty-two patients, mean age 50 +/- 21 years, 39 female, were studied. Mean duration of symptoms was 5 years. Average frequency of attacks was one episode per week. INTERVENTIONS: Detailed semi-structured questionnaires were completed regarding presenting symptoms. RESULTS: In over one-third of patients, episodes occurred suddenly, with no prodromal features. In those with prodrome, 71% had autonomic symptoms, but 27% had palpitations or dyspnoea and 21% had chest pain. Eleven percent of patients denied known provocative features. In the remainder, the most common were prolonged standing (37%), hot weather (27%) and lack of food (23%). One-fifth had symptoms sitting and 5% whilst driving. Seventy-five percent of patients suffered after effects, the most common being severe fatigue. Over half sustained an injury during syncope, and 13% sustained a fracture. Unwitnessed episodes occurred in 25%. Pallor was reported in half the cases, sweating in 13% and myoclonus in 5%. CONCLUSIONS: Atypical presentations of VVS occur in many patients referred to a tertiary referral centre. Knowledge of the clinical characteristics of unexplained syncope for which VVS is the attributable diagnosis should assist in appropriate management of such patients.
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