Abstract
Objective
Situational syncope is a subtype of neurally mediated syncope and associated with
specific circumstances. This paper is to assess the clinical characteristics and underlying
causes of situational syncope.
Methods
This is a retrospective study of patients who underwent head-up tilt testing (HUTT).
Medical records including age at HUTT, gender, number of syncopal episodes, family
history of syncope, triggers before the syncopal episode, position during the syncopal
episode and the responses to HUTT were reviewed.
Results
Among 3140 patients, 354 patients (mean age 28.3 ± 16.6 years old, with 184 males
and 170 females) were diagnosed with situational syncope. The causes of situational
syncope included micturition (50.85%), defecation (15.82%), bathing (10.45%), swallowing
(6.50%), cough (4.80%), post-dinner (3.95%), singing (3.11%), teeth brushing (2.26%),
and hair grooming (2.26%). Patients with syncope triggered by micturition, cough,
post-dinner were more likely to be men, while those caused by bathing, swallowing,
singing, teeth brushing and hair grooming were more likely to be women. 34.75% of
patients with situational syncope were between the ages of 10–19 years old, and 20.34%
were between the ages of 40–49 years old. 74.01% of situational syncopal events occurred
in an upright position. 47.74% of patients had positive responses to HUTT.
Conclusions
These findings show that micturition was the most common cause of situational syncope
in both children and adults. There were significant gender and age differences among
situational syncope triggered by different causes. Most of situational syncope occurred
in the upright position and nearly half of the patients had positive responses to
HUTT.
Abbreviations:
ECG (electrocardiogram), HUTT (head-up tilt testing), OH (orthostatic hypotension), OHT (orthostatic hypertension), POTS (postural orthostatic tachycardia syndrome), VVS (vasovagal syncope), VVS-V (vasodepressor response of vasovagal syncope), VVS-C (cardioinhibitory response of vasovagal syncope), mixed VVS (mixed response of vasovagal syncope)Keywords
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Article Info
Publication History
Published online: November 29, 2019
Accepted:
November 26,
2019
Received in revised form:
November 21,
2019
Received:
July 1,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
