Raj Satish R, Sheldon Robert S
Faculty of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive, NW, Calgary, Alberta, T2N 4N1, Canada.
Curr Cardiol Rep. 2002 Sep;4(5):363-70. doi: 10.1007/s11886-002-0035-3.
Syncope is a common condition that can be both disabling and expensive to treat. Although investigative modalities are sometimes required, a diagnosis can often be made with a good history and physical exam. Recent reports have identified specific historic features that are more suggestive of cardiac syncope as compared with vasovagal syncope and seizures. Advances in ambulatory electrocardiography (in particular the implantable loop recorder) have proven invaluable in both difficult-to-diagnose syncope, and in advancing our knowledge of its mechanisms. When clear dysrhythmias are manifest, appropriate therapies are self-evident. However, recurrent vasovagal syncope continues to be a condition that can be difficult to treat. Fortunately, there are well-conducted trials of both pharmacologic therapies (b-blockers, alpha agonists, and selective serotonin reuptake inhibitors) and nonpharmacologic treatments (orthostatic physical training and dual-chamber pacemakers) that should provide more guidance in the near future.
晕厥是一种常见病症，可能导致功能障碍且治疗费用高昂。尽管有时需要进行检查手段，但通过详细的病史和体格检查通常就能做出诊断。最近的报告已经确定了一些特定的病史特征，与血管迷走性晕厥和癫痫相比，这些特征更提示为心源性晕厥。动态心电图（尤其是植入式环路记录器）的进展在难以诊断的晕厥以及增进我们对其机制的了解方面都已证明具有极高价值。当明显出现心律失常时，适当的治疗方法不言而喻。然而，复发性血管迷走性晕厥仍然是一种难以治疗的病症。幸运的是，针对药物治疗（β受体阻滞剂、α激动剂和选择性5-羟色胺再摄取抑制剂）和非药物治疗（体位性体育锻炼和双腔起搏器）都有开展良好的试验，这些试验在不久的将来应该会提供更多指导。
