Takase B, Goto T, Nagai T, Uehata A, Isojima K, Ohtomi S, Ohta S, Takemoto T, Kurita A, Nakamura H
Department of Internal Medicine, Self Defense Force Central Hospital, Tokyo, Japan.
Jpn Circ J. 1997 Jun;61(6):525-30. doi: 10.1253/jcj.61.525.
Head-up tilt testing is widely used in the diagnosis of syncope of unknown origin. In this report, head-up tilt testing elucidated the etiology of cardiac asystole of unexpected and sudden onset during orthopedic surgery under epidural anesthesia in a 30-year-old woman. Conventional diagnostic approaches were ineffective. Venous pooling in the lower legs as a result of vasodilation and subsequent vagotony due to epidural anesthesia, a condition mimicking orthostatic stress, is proposed as the mechanism of asystole. Follow-up examinations over 16 months revealed no further syncope and a good clinical course. Head-up tilt testing was useful in determining etiology in this case.
头高位倾斜试验广泛应用于不明原因晕厥的诊断。在本报告中，头高位倾斜试验明确了一名30岁女性在硬膜外麻醉下进行骨科手术期间意外突发心脏停搏的病因。传统的诊断方法无效。硬膜外麻醉导致血管扩张，进而引起小腿静脉淤积，随后出现迷走神经张力增加，这种类似直立位应激的情况被认为是心脏停搏的机制。16个月的随访检查显示未再发生晕厥，临床病程良好。头高位倾斜试验在该病例中有助于确定病因。
