Hart G T
Robert Wood Johnson Medical School/Cooper Medical Center, Camden, New Jersey, USA.
Am Fam Physician. 1995 Jun;51(8):1941-8, 1951-2.
Syncopal episodes are relatively common. A variety of etiologies can underlie syncope, and the cause is often multifactorial. A thorough history and a complete physical examination are essential initial components in the evaluation of a patient with syncope. Prodromal symptoms often accompany fainting of vasovagal origin, while the occurrence of syncope without warning in a patient with cardiac problems suggests arrhythmia. Many medications, including antihypertensives, antidepressants and digitalis, may be responsible for episodes of fainting. The physical examination of a patient with a history of syncope includes measurement of orthostatic blood pressure, as well as careful cardiovascular and neurologic evaluations. The decision to use ancillary laboratory and electrocardiographic testing is guided by the patient's history and the findings on physical examination. Although new technologies, such as loop electrocardiography and tilt table tests, can aid in the diagnosis of syncope, they should not be used routinely.
晕厥发作相对常见。多种病因可导致晕厥，其病因往往是多因素的。详尽的病史和全面的体格检查是评估晕厥患者必不可少的初始环节。前驱症状常伴随血管迷走性晕厥发作，而心脏问题患者无预警地发生晕厥提示心律失常。许多药物，包括抗高血压药、抗抑郁药和洋地黄，可能导致晕厥发作。有晕厥病史患者的体格检查包括测量直立位血压，以及仔细的心血管和神经系统评估。辅助实验室检查和心电图检查的决策依据是患者的病史和体格检查结果。尽管新技术，如动态心电图监测和倾斜试验，有助于晕厥的诊断，但不应常规使用。
