Syncope Unit, Geriatric and Intensive Care Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy.
Medicina (Kaunas). 2021 Jun 11;57(6):603. doi: 10.3390/medicina57060603.
The rate of syncope in the Emergency Department ranges between 0.9 and 1.7%. Syncope is mostly related to a underlying reflex or orthostatic mechanism. A bradycardic or a hypotensive phenotype, may be identified. The latter is the most common and could be constitutional or drug induced. Consequently, obtaining an accurate drug history is an important step of the initial assessment of syncope. As anti-hypertensive medication might be responsible for orthostatic hypotension, managing hypertension in patients with syncope requires finding an ideal balance between hypotensive and cardiovascular risks. The choice of anti-hypertensive molecule as well as the therapeutic regimen and dosage, influences the risk of syncope. Not only could anti-hypertensive drugs have a hypotensive effect but opioids and psychoactive medications may also be involved in the mechanism of syncope. Proper drug management could reduce syncope recurrences and their consequences.
急诊科晕厥的发生率在 0.9%至 1.7%之间。晕厥主要与潜在的反射或直立性机制有关。可能会出现心动过缓和低血压的表现。后者最为常见，可能是由体质因素或药物引起的。因此，获取准确的药物史是晕厥初始评估的重要步骤。由于抗高血压药物可能导致直立性低血压，因此在治疗晕厥患者的高血压时，需要在低血压和心血管风险之间找到一个理想的平衡点。降压药物的选择以及治疗方案和剂量都会影响晕厥的风险。抗高血压药物不仅可能有降压作用，阿片类药物和精神类药物也可能参与晕厥的发生机制。正确的药物管理可以降低晕厥的复发率及其后果。
