Calkins H, Shyr Y, Frumin H, Schork A, Morady F
Department of Cardiology, University of Michigan, Ann Arbor, USA.
Am J Med. 1995 Apr;98(4):365-73. doi: 10.1016/S0002-9343(99)80315-5.
The present study was undertaken to identify and quantitate the symptoms associated with neurocardiogenic syncope, syncope due to ventricular tachycardia, and syncope resulting from atrioventricular block.
Eighty patients referred for evaluation of syncope in whom a diagnosis of neurocardiogenic syncope, atrioventricular block, or ventricular tachycardia was established were studied. Each patient was interviewed using a standard questionnaire. The clinical histories were then compared to identify which variables best differentiated the cause of syncope.
The clinical histories of patients with syncope due to ventricular tachycardia and atrioventricular block were similar. Only age, the duration of prodromal symptoms, diaphoresis prior to syncope, and fatigue following syncope differed. In contrast, the clinical history in patients with neurocardiogenic syncope differed greatly from that obtained in patients with syncope due to atrioventricular block or ventricular tachycardia. Features of the clinical history that were predictive of syncope due to atrioventricular block or ventricular tachycardia were male sex, age > 54 years, < or = 2 episodes of syncope, and a duration of warning of < or = 5 seconds. Features of the clinical history predictive of syncope not due to ventricular tachycardia or atrioventricular block were palpitations, blurred vision, nausea, warmth, diaphoresis, or lightheadedness prior to syncope, and nausea, warmth, diaphoresis, or fatigue following syncope.
The results of this study identify and compare the features of the clinical history obtained in patients with syncope due to ventricular tachycardia, atrioventricular block, and neurocardiogenic syncope and demonstrate that the clinical history is of value in distinguishing patients with these three causes of syncope.
本研究旨在识别和量化与神经心源性晕厥、室性心动过速所致晕厥以及房室传导阻滞所致晕厥相关的症状。
对80例因晕厥前来评估且已确诊为神经心源性晕厥、房室传导阻滞或室性心动过速的患者进行了研究。采用标准问卷对每位患者进行访谈。然后比较临床病史，以确定哪些变量最能区分晕厥的病因。
室性心动过速和房室传导阻滞所致晕厥患者的临床病史相似。仅年龄、前驱症状持续时间、晕厥前出汗情况以及晕厥后疲劳程度存在差异。相比之下，神经心源性晕厥患者的临床病史与房室传导阻滞或室性心动过速所致晕厥患者的临床病史有很大不同。预测房室传导阻滞或室性心动过速所致晕厥的临床病史特征为男性、年龄>54岁、晕厥发作次数≤2次以及预警持续时间≤5秒。预测非室性心动过速或房室传导阻滞所致晕厥的临床病史特征为晕厥前心悸、视力模糊、恶心、潮热、出汗或头晕，以及晕厥后恶心、潮热、出汗或疲劳。
本研究结果识别并比较了室性心动过速、房室传导阻滞和神经心源性晕厥所致晕厥患者的临床病史特征，表明临床病史对区分这三种晕厥病因的患者具有价值。
