Bosch Ralph
Cardio Centrum Ludwigsburg-Bietigheim (CCLB), Asperger Str. 48, 71634, Ludwigsburg, Deutschland.
Herzschrittmacherther Elektrophysiol. 2021 Sep;32(3):330-334. doi: 10.1007/s00399-021-00775-2. Epub 2021 Jun 29.
This review discusses important aspects of pathophysiology, diagnosis and therapy of reflex syncope. The autonomic nervous system plays a crucial role in the origin of this frequently observed form of syncope. In most cases, reflex syncopes occur under specific circumstances. Thus, a detailed history is essential. Besides a physical exam und a normal 12-lead ECG, dedicated tests like tilt-table-testing, carotid massage and the implantation of a loop recorder often assist in making the correct diagnosis. The basis of therapy for all patients is reassurance about the benign course of the disease as well as education about adequate measures. Pharmacotherapy is reserved to a minority of patients. In older patients with repeat or severe syncopes and documented asystoles, pacemaker therapy is a valuable option.
本综述讨论了反射性晕厥的病理生理学、诊断和治疗的重要方面。自主神经系统在这种常见的晕厥形式的发生中起着关键作用。在大多数情况下，反射性晕厥发生在特定的情况下。因此，详细的病史至关重要。除了体格检查和正常的12导联心电图外，倾斜试验、颈动脉按摩和植入环路记录仪等专门检查通常有助于做出正确诊断。所有患者治疗的基础是让患者放心疾病的良性病程以及对适当措施的教育。药物治疗仅适用于少数患者。对于反复发生或严重晕厥且记录有心脏停搏的老年患者，起搏器治疗是一个有价值的选择。
