VALUE OF PRODROMAL SIGNS AND SYMPTOMS IN THE DIFFERENTIAL DIAGNOSIS OF CARDIOGENIC AND NEUROGENIC SYNCOPE
P.J. Stryjewski, B. Nessler, A. Kuczaj, E. Nowalany-Kozielska, J. Nessler
1. Cardiology Department, Chrzanow City Hospital, Poland; 2.Coronary Disease Department, Institute of Cardiology, Medical School of Jagiellonian University, John Paul II Hospital, Cracow, Poland; 3. 32nd Department of Cardiology, Zabrze, Medical University of Silesia, Katowice, Poland
Background: The aim of the study was to evaluate the clinical signs and symptoms in the differential diagnosis of syncope
Methods: We investigated 160 patients (64 men and 96 women), aged 18-77 years with reflex or cardiac syncope over the last 3 years. The following were investigated: age, sex, age at first syncope, number of presyncopal episodes, number of syncopal episodes, number of sudden syncope without prodromal signs and the circumstances of syncope (in standing, sitting or lying position, during walking, in crowded and warm places) (Table 1). Moreover, we assessed the frequencies of prodromal signs (general weakness, dyspnea, heart palpitations, cold sweats, feeling of cold or heat, visual disturbances, tinnitus, headache, stomachache, nausea) in the differential diagnosis of syncope (Table 2).
Results: Patients with reflex syncope were younger compared to patients with cardiac syncope (41.3±16.5 vs. 61.8±12.8; P < 0.001) and had lower weight and body mass index (BMI). Reflex syncope patients more often presented with presyncope (16.8±21.3 vs. 3.2±4.4; P < 0.001) and syncope (8.1±7.8 vs. 5.4±1.6; P < 0.001). Dyspnea, heart palpitations, feeling of cold or heat, visual disturbances and tinnitus were associated with reflex syncope (P < 0.01)Conclusions: The course of syncope may facilitate a diagnostic process of reflex and cardiac syncope.
