Watanabe K, Inomata T, Miyakita Y, Takahashi M, Suzuki T, Koyama S, Ohshima M, Suzuki K, Masani F, Aizawa Y
Division of Cardiology, Tsubame Rosai Hospital, Niigata, Japan.
Jpn Heart J. 1993 Mar;34(2):171-82. doi: 10.1536/ihj.34.171.
A total of 38 patients with syncope in whom a cause was not assigned or suggested by the initial history, physical examination and electrocardiography (ECG) were studied. Twenty-four patients underwent cardiac examination with Holter ECG, electrophysiologic testing with programmed ventricular stimulation (EPS) and/or coronary arteriography including ergonovine provocation (ergonovine CAG). The study with Holter ECG, EPS and ergonovine CAG yielded a presumptive diagnosis in 36 patients (36/38 = 95%), 11 with vasopastic angina, 7 with ventricular tachycardia, 4 with ischemic heart disease, 9 with sick sinus syndrome (SSS), 1 with drug induced SSS, 3 with A-V block, 1 with supraventricular tachycardia, 1 with hypertrophic cardiomyopathy, 1 with aortic valve stenosis and 1 with carotid sinus syndrome (included are 1 patient with ventricular tachycardia+ischemic heart disease, 1 with SSS+vasopastic angina and 1 with ventricular tachycardia+vasospastic angina). Therapy based on these findings provided complete symptomatic relief in all patients during a mean follow up of 25 +/- 10 months (range 5-45 months). In conclusion, EPS and ergonovine CAG are useful in the diagnosis and therapy of unexplained syncope.
对38例晕厥患者进行了研究，这些患者最初的病史、体格检查和心电图（ECG）均未明确病因或提示病因。24例患者接受了心脏检查，包括动态心电图、心室程序刺激（EPS）电生理检查和/或冠状动脉造影（包括麦角新碱激发试验，即麦角新碱冠状动脉造影）。动态心电图、EPS和麦角新碱冠状动脉造影检查对36例患者（36/38 = 95%）做出了初步诊断，其中11例为变异性心绞痛，7例为室性心动过速，4例为缺血性心脏病，9例为病态窦房结综合征（SSS），1例为药物性SSS，3例为房室传导阻滞，1例为室上性心动过速，1例为肥厚型心肌病，1例为主动脉瓣狭窄，1例为颈动脉窦综合征（包括1例室性心动过速合并缺血性心脏病患者、1例SSS合并变异性心绞痛患者和1例室性心动过速合并变异性心绞痛患者）。基于这些检查结果进行的治疗，使所有患者在平均25±10个月（5 - 45个月）的随访期间症状完全缓解。总之，EPS和麦角新碱冠状动脉造影对不明原因晕厥的诊断和治疗很有用。
