Becker A, Noachtar S, Reithmann C, Brandt T, Steinbeck G
Medizinische Klinik und Poliklinik I, Klinikum Grosshadern der Ludwig-Maximilians-Universität München.
Internist (Berl). 2005 Sep;46(9):994, 996-1000, 1002-5. doi: 10.1007/s00108-005-1475-9.
Syncope is one of the most common symptoms leading to hospital admission. Thereby syncope can be induced by several diseases. It is crucial to detect underlying structural heart disease or high grade arrhythmias, as these are associated with an increased mortality. The careful history and physical examination can often give sufficient evidence to evaluate the origin of syncope. Additional examinations should only be applied selectively. In patients with structural heart disease the specific treatment should be initiated, in patients with cardiac arrhythmias the implantation of a pacemaker or ICD might be indicated. The most common neurally-mediated and orthostatic syncopes can often be treated successfully by physical training. Beside syncope epilepsy might be responsible for a transient loss of consciousness. Again careful history taking helps to differentiate between these two entities.
晕厥是导致住院的最常见症状之一。晕厥可由多种疾病诱发。检测潜在的结构性心脏病或高度心律失常至关重要，因为这些与死亡率增加相关。仔细的病史采集和体格检查通常能提供足够的证据来评估晕厥的病因。仅应选择性地进行额外检查。对于有结构性心脏病的患者，应开始特定治疗；对于有心律失常的患者，可能需要植入起搏器或植入式心律转复除颤器（ICD）。最常见的神经介导性和体位性晕厥通常可通过体育锻炼成功治疗。除晕厥外，癫痫也可能导致短暂意识丧失。同样，仔细的病史采集有助于区分这两种情况。
