Ammirati F, Colivicchi F, Velardi A, Santini M
Department of Heart Diseases, S. Filippo Neri Hospital, Rome, Italy.
Ital Heart J. 2001 Jan;2(1):38-41.
Vasovagal syncope represents the most common form of syncope in the general population and is usually considered as a benign affection. However, syncope-related traumatic injuries may represent a major complication of such a condition in a relevant percentage of cases. The aim of this study was to assess the prevalence and clinical correlates of syncope-related trauma in a cohort of consecutive patients with recurrent vasovagal syncope.
Three hundred and forty-six consecutive patients were studied in whom a diagnosis of vasovagal syncope was established. All subjects were interviewed with a standard questionnaire in order to collect all possible information about their clinical history and the occurrence of trauma during syncopal spells.
Ninety-four of the 346 patients (27.2%) reported at least one syncope-related traumatic injury. In 31/346 cases (8.9%) the severity of trauma had determined hospital admission and surgical treatment. When compared to the rest of the study population, patients with syncope-related trauma showed a higher prevalence of male gender (p < 0.01), a higher absolute number (p < 0.01) and frequency (p < 0.01) of syncopal episodes in their history. Patients with trauma also reported a shorter duration of warning symptoms preceding syncope (p < 0.01), while showing a higher prevalence of positive cardioinhibitory response to tilt table testing (p < 0.01). Moreover, the number of syncope-related injuries was found to correlate significantly with the number of syncopal spells (r = 0.64, p < 0.01).
Most practicing physicians consider vasovagal syncope as simply a benign affection in young people. However, such a clinical view should be partially revised, as recurrent vasovagal syncope is associated with significant trauma-related morbidity.
血管迷走性晕厥是普通人群中最常见的晕厥形式，通常被认为是一种良性病症。然而，在相当比例的病例中，与晕厥相关的创伤性损伤可能是这种病症的主要并发症。本研究的目的是评估一组连续性复发性血管迷走性晕厥患者中与晕厥相关创伤的患病率及其临床相关性。
对346例连续性患者进行了研究，这些患者均被确诊为血管迷走性晕厥。所有受试者均接受了标准问卷调查，以收集有关其临床病史以及晕厥发作期间创伤发生情况的所有可能信息。
346例患者中有94例（27.2%）报告至少有一次与晕厥相关的创伤性损伤。在31/346例（8.9%）病例中，创伤的严重程度导致了住院治疗和手术治疗。与研究人群的其他患者相比，有与晕厥相关创伤的患者男性患病率更高（p<0.01），其病史中晕厥发作的绝对次数（p<0.01）和频率（p<0.01）更高。有创伤的患者还报告晕厥前预警症状持续时间较短（p<0.01），同时对倾斜试验的心脏抑制反应阳性患病率更高（p<0.01）。此外，发现与晕厥相关的损伤数量与晕厥发作次数显著相关（r=0.64，p<0.01）。
大多数执业医生认为血管迷走性晕厥只是年轻人中的一种良性病症。然而，这种临床观点应部分修正，因为复发性血管迷走性晕厥与显著的创伤相关发病率有关。
