Tilt table testing in the diagnostic evaluation of presyncope and syncope

A case-series report

E. S. Prakash, Madanmohan, Sunil K. Narayan, Uday Prashanth, M. G. Kamath, Kaviraja Udupa, K. R. Sethuraman, S. Srinivasan, R. Anil Kumar

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Tilt table testing has long been used as a standard tool in the diagnostic evaluation of syncope. However, differences of opinion exist with regard to its utility in the evaluation of patients with only presyncopal attacks. We present the results of drug-free, 70-degree head-up tilt table tests (maximum duration of 45 minutes), conducted between May 2002 and May 2003 in the Department of Physiology at JIPMER. This series consisted of both male and female patients (age 6-79 yr) with presyncope (n = 43), unexplained syncope (n = 43) and asymptomatic healthy volunteers without a history of syncope (n = 14). 28 out of 43 patients with unexplained syncope had a history of recurrent syncope while the remaining 15 had only 1 episode. 2 out of 43 patients (4.6%) with a history of only presyncopal attacks had a positive test (induction of intense presyncope and/or syncope accompanied by hypotension and/or a relative bradycardia). 21 out of 43 patients (49%) with a history of syncope had a positive test. 7 had vasodepressor syncope due to hypotension, 6 had cardioinhibitory syncope characterized by asystole and 10 had a mixed form of the vasovagal syndrome characterized by hypotension as well as bradycardia. 18 out of 28 patients (64%) with recurrent unexplained syncope had a positive test. All fourteen healthy volunteers had a negative test. We conclude that tilt table testing is useful in the diagnostic evaluation of patients with unexplained syncope, especially those with recurrent syncope, but not in the evaluation of patients with presyncope alone.

Original languageEnglish
Pages (from-to)213-218
Number of pages6
JournalIndian Journal of Physiology and Pharmacology
Volume48
Issue number2
Publication statusPublished - 01-04-2004

Fingerprint

Syncope
Hypotension
Bradycardia
Healthy Volunteers
Tilt-Table Test
Vasovagal Syncope
Heart Arrest

All Science Journal Classification (ASJC) codes

  • Physiology
  • Pharmacology
  • Physiology (medical)

Cite this

Prakash, E. S., Madanmohan, Narayan, S. K., Prashanth, U., Kamath, M. G., Udupa, K., ... Kumar, R. A. (2004). Tilt table testing in the diagnostic evaluation of presyncope and syncope: A case-series report. Indian Journal of Physiology and Pharmacology, 48(2), 213-218.
Prakash, E. S. ; Madanmohan ; Narayan, Sunil K. ; Prashanth, Uday ; Kamath, M. G. ; Udupa, Kaviraja ; Sethuraman, K. R. ; Srinivasan, S. ; Kumar, R. Anil. / Tilt table testing in the diagnostic evaluation of presyncope and syncope : A case-series report. In: Indian Journal of Physiology and Pharmacology. 2004 ; Vol. 48, No. 2. pp. 213-218.
@article{a93230d81a3e4bbfa05c4e57a8d70a97,
title = "Tilt table testing in the diagnostic evaluation of presyncope and syncope: A case-series report",
abstract = "Tilt table testing has long been used as a standard tool in the diagnostic evaluation of syncope. However, differences of opinion exist with regard to its utility in the evaluation of patients with only presyncopal attacks. We present the results of drug-free, 70-degree head-up tilt table tests (maximum duration of 45 minutes), conducted between May 2002 and May 2003 in the Department of Physiology at JIPMER. This series consisted of both male and female patients (age 6-79 yr) with presyncope (n = 43), unexplained syncope (n = 43) and asymptomatic healthy volunteers without a history of syncope (n = 14). 28 out of 43 patients with unexplained syncope had a history of recurrent syncope while the remaining 15 had only 1 episode. 2 out of 43 patients (4.6{\%}) with a history of only presyncopal attacks had a positive test (induction of intense presyncope and/or syncope accompanied by hypotension and/or a relative bradycardia). 21 out of 43 patients (49{\%}) with a history of syncope had a positive test. 7 had vasodepressor syncope due to hypotension, 6 had cardioinhibitory syncope characterized by asystole and 10 had a mixed form of the vasovagal syndrome characterized by hypotension as well as bradycardia. 18 out of 28 patients (64{\%}) with recurrent unexplained syncope had a positive test. All fourteen healthy volunteers had a negative test. We conclude that tilt table testing is useful in the diagnostic evaluation of patients with unexplained syncope, especially those with recurrent syncope, but not in the evaluation of patients with presyncope alone.",
author = "Prakash, {E. S.} and Madanmohan and Narayan, {Sunil K.} and Uday Prashanth and Kamath, {M. G.} and Kaviraja Udupa and Sethuraman, {K. R.} and S. Srinivasan and Kumar, {R. Anil}",
year = "2004",
month = "4",
day = "1",
language = "English",
volume = "48",
pages = "213--218",
journal = "Indian Journal of Physiology and Pharmacology",
issn = "0019-5499",
publisher = "Association of Physiologists and Pharmacologists of India",
number = "2",

}

Prakash, ES, Madanmohan, Narayan, SK, Prashanth, U, Kamath, MG, Udupa, K, Sethuraman, KR, Srinivasan, S & Kumar, RA 2004, 'Tilt table testing in the diagnostic evaluation of presyncope and syncope: A case-series report', Indian Journal of Physiology and Pharmacology, vol. 48, no. 2, pp. 213-218.

Tilt table testing in the diagnostic evaluation of presyncope and syncope : A case-series report. / Prakash, E. S.; Madanmohan; Narayan, Sunil K.; Prashanth, Uday; Kamath, M. G.; Udupa, Kaviraja; Sethuraman, K. R.; Srinivasan, S.; Kumar, R. Anil.

In: Indian Journal of Physiology and Pharmacology, Vol. 48, No. 2, 01.04.2004, p. 213-218.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Tilt table testing in the diagnostic evaluation of presyncope and syncope

T2 - A case-series report

AU - Prakash, E. S.

AU - Madanmohan,

AU - Narayan, Sunil K.

AU - Prashanth, Uday

AU - Kamath, M. G.

AU - Udupa, Kaviraja

AU - Sethuraman, K. R.

AU - Srinivasan, S.

AU - Kumar, R. Anil

PY - 2004/4/1

Y1 - 2004/4/1

N2 - Tilt table testing has long been used as a standard tool in the diagnostic evaluation of syncope. However, differences of opinion exist with regard to its utility in the evaluation of patients with only presyncopal attacks. We present the results of drug-free, 70-degree head-up tilt table tests (maximum duration of 45 minutes), conducted between May 2002 and May 2003 in the Department of Physiology at JIPMER. This series consisted of both male and female patients (age 6-79 yr) with presyncope (n = 43), unexplained syncope (n = 43) and asymptomatic healthy volunteers without a history of syncope (n = 14). 28 out of 43 patients with unexplained syncope had a history of recurrent syncope while the remaining 15 had only 1 episode. 2 out of 43 patients (4.6%) with a history of only presyncopal attacks had a positive test (induction of intense presyncope and/or syncope accompanied by hypotension and/or a relative bradycardia). 21 out of 43 patients (49%) with a history of syncope had a positive test. 7 had vasodepressor syncope due to hypotension, 6 had cardioinhibitory syncope characterized by asystole and 10 had a mixed form of the vasovagal syndrome characterized by hypotension as well as bradycardia. 18 out of 28 patients (64%) with recurrent unexplained syncope had a positive test. All fourteen healthy volunteers had a negative test. We conclude that tilt table testing is useful in the diagnostic evaluation of patients with unexplained syncope, especially those with recurrent syncope, but not in the evaluation of patients with presyncope alone.

AB - Tilt table testing has long been used as a standard tool in the diagnostic evaluation of syncope. However, differences of opinion exist with regard to its utility in the evaluation of patients with only presyncopal attacks. We present the results of drug-free, 70-degree head-up tilt table tests (maximum duration of 45 minutes), conducted between May 2002 and May 2003 in the Department of Physiology at JIPMER. This series consisted of both male and female patients (age 6-79 yr) with presyncope (n = 43), unexplained syncope (n = 43) and asymptomatic healthy volunteers without a history of syncope (n = 14). 28 out of 43 patients with unexplained syncope had a history of recurrent syncope while the remaining 15 had only 1 episode. 2 out of 43 patients (4.6%) with a history of only presyncopal attacks had a positive test (induction of intense presyncope and/or syncope accompanied by hypotension and/or a relative bradycardia). 21 out of 43 patients (49%) with a history of syncope had a positive test. 7 had vasodepressor syncope due to hypotension, 6 had cardioinhibitory syncope characterized by asystole and 10 had a mixed form of the vasovagal syndrome characterized by hypotension as well as bradycardia. 18 out of 28 patients (64%) with recurrent unexplained syncope had a positive test. All fourteen healthy volunteers had a negative test. We conclude that tilt table testing is useful in the diagnostic evaluation of patients with unexplained syncope, especially those with recurrent syncope, but not in the evaluation of patients with presyncope alone.

UR - http://www.scopus.com/inward/record.url?scp=1842576516&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1842576516&partnerID=8YFLogxK

M3 - Article

VL - 48

SP - 213

EP - 218

JO - Indian Journal of Physiology and Pharmacology

JF - Indian Journal of Physiology and Pharmacology

SN - 0019-5499

IS - 2

ER -