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- Title
Çocuk ve ergenlerde vazovagal senkop tanısında izosorbid dinitrat sprey ile uyarılmış "tilt" testinin kullanımı.
- Authors
Ergül, Yakup; Nişli, Kemal; Dindar, Aygün; Aydoğan, Ümrah; Ömeroğlu, Rukiye Eker; Ertuğrul, Türkan
- Abstract
Aim: Vasovagal syncope (neurocardiogenic) is the most common cause of syncope in childhood. It is generally more common among adolescent girls and rare before the age of 10 years. Head-up tilt table test provides the ability to provoke vasovagal test and helps to document the type of response by cardiac rhythm and blood pressure monitorization. If basal tilt test is negative, pharmacologic stimulation with isoproterenol or isosorbide dinitrate (ISDN) administiration may increase the sensitivity of the test. Material and Method: In this study, 88 patients aged 9-18 years having repeated, unexplored syncope were evaluated by tilt test (at 70° for 30 minutes). The patients who did not develop syncope by this test were given 400 micrograms of ISDN spray sublingually and were kept under close monitoring until the findings were seen or if not, for 15 minutes. Results: Twentyfour patients (37%) had a positive basal tilt test. Forty patients (46%) had syncope following ISDN administration. No side effect related to ISDN administration was observed. The types of positive responses were mixed type in 37 patients (58%), cardioinhibitory without asystole in six patients (%9), cardioinhibitory with asystole in seven patients (%11) and vasodepressor types in 14 patients (22%) respectively. Conclusions: This study concludes that, pharmacological stimulation with sublingual ISDN is safe and easy to perform in children considered to have vasovagal syncope clinically and helps to increase the diagnostic value of tilt testing.
- Subjects
SYNCOPE; JUVENILE diseases; HEART diseases; ISOPROTERENOL; CARDIOVASCULAR agents
- Publication
Türk Pediatri Arşivi, 2009, Vol 44, Issue 3, p94
- ISSN
1306-0015
- Publication type
Article