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Syncope review

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https://www.readbyqxmd.com/read/29666096/devil-is-in-the-detail
#1
John Roshan Jacob, Amal Paul, Anoop George Alex
A 15-year-old girl of Asian origin, hailing from a rural agrarian background, presented with history of multiple episodes of dizziness for 3 years. The episodes were precipitated mostly by emotional and/or physical stress and relieved on lying down, with a few episodes culminating in transient loss of consciousness. As preliminary cardiac and neurological evaluation were normal, she was being treated by the primary physician as a case of probable psychogenic syncope, supported by the consistent association of the episodes with emotional stress...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29663142/do-we-need-a-cool-down-after-exercise-a-narrative-review-of-the-psychophysiological-effects-and-the-effects-on-performance-injuries-and-the-long-term-adaptive-response
#2
REVIEW
Bas Van Hooren, Jonathan M Peake
It is widely believed that an active cool-down is more effective for promoting post-exercise recovery than a passive cool-down involving no activity. However, research on this topic has never been synthesized and it therefore remains largely unknown whether this belief is correct. This review compares the effects of various types of active cool-downs with passive cool-downs on sports performance, injuries, long-term adaptive responses, and psychophysiological markers of post-exercise recovery. An active cool-down is largely ineffective with respect to enhancing same-day and next-day(s) sports performance, but some beneficial effects on next-day(s) performance have been reported...
April 16, 2018: Sports Medicine
https://www.readbyqxmd.com/read/29649189/acute-metam-sodium-poisoning-caused-by-occupational-exposure-at-a-flower-farm-uganda-october-2016
#3
Susan Nakubulwa, Joy Kusiima, Daniel Kadobera, Joan N Mutyoba, Alex R Ario, Bao-Ping Zhu
On October 25, 2016, media reports alerted the Uganda Ministry of Health to an outbreak of >80 cases of vomiting, syncope, and acute diarrhea among workers at a flower farm in central Uganda; 27 workers were hospitalized. On November 1, an investigation was undertaken by the Uganda Public Health Fellowship Program.* A case-control study found that working inside greenhouse 7, which had been fumigated with the organosulfur compound metam sodium the night of October 13, was strongly associated with illness...
April 13, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29625280/long-qt-syndrome-type-5-lite-defining-the-clinical-phenotype-associated-with-the-potentially-pro-arrhythmic-p-asp85asn-kcne1-common-genetic-variant
#4
Conor Lane, John R Giudicessi, Dan Ye, David J Tester, Ram K Rohatgi, J Martijn Bos, Michael J Ackerman
BACKGROUND: Long QT syndrome (LQTS) genetic test reports commonly exclude potentially pro-arrhythmic common variants such as p.Asp85Asn-KCNE1. OBJECTIVE: To determine if a discernible phenotype is associated with p.Asp85Asn-KCNE1 and if relatively common KCNE1 variants underlie transient QT prolongation pedigrees with negative commercial LQTS genetic tests. METHODS: Retrospective review was used to compare demographics, symptomatology, and QT parameters of individuals with p...
April 3, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29622324/pediatric-syncope-high-risk-conditions-and-reasonable-approach
#5
REVIEW
Paul C Schunk, Tim Ruttan
Syncope is a common presentation to the emergency room. Unlike in the adult population, most pediatric syncope has non-life-threatening causes, and minimal evaluation in the emergency department is appropriate with parental reassurance. Despite this benign prognosis, care must be made to find uncommon and potentially fatal causes. The primary purpose of evaluation of the patient with syncope is to determine whether the patient is at increased risk for death and needs either admission to the hospital or an expedited outpatient evaluation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29600123/association-between-baseline-blood-pressures-heart-rates-and-vasovagal-syncope-in-children-and-adolescents
#6
Himanshu Adlakha, Ruchi Gupta, Romana Hassan, Jeffrey H Kern
BACKGROUND: Vasovagal syncope is the most common cause of syncope in children and adults, accounting for 50-66% of unexplained syncope. There are no studies establishing the relationship between syncope, baseline heart rate, and blood pressure. OBJECTIVE: To identify a possible association between baseline blood pressure and heart rate with syncope. DESIGN/METHODS: We conducted a questionnaire-based chart review study. A questionnaire was distributed to the guardian of children between eight and 18 years of age who attended the Pediatric Ambulatory Care Clinic at Flushing Hospital Medical Center...
January 28, 2018: Curēus
https://www.readbyqxmd.com/read/29589804/age-dependent-physiological-changes-medicines-and-sex-influenced-types-of-falls
#7
Snezana Kusljic, Sachin Perera, Elizabeth Manias
Background/Study context: We investigated various parameters related to falls including age-dependent physiological changes, regular medicine use and different types of falls experienced. There is a lack of research investigating the impact of health status, sex, polypharmacy and ageing on different types of falls such as unspecified fall on the same level, mechanical fall on the same level relating to slipping, tripping or loosing balance, fall from a chair, vehicle and fall as a result of syncope, fall from steps or stairs and fall from the height...
March 28, 2018: Experimental Aging Research
https://www.readbyqxmd.com/read/29576105/perioperative-management-of-patients-with-congenital-or-acquired-disorders-of-the-qt-interval
#8
REVIEW
M O'Hare, Y Maldonado, J Munro, M J Ackerman, H Ramakrishna, D Sorajja
QT prolongation can be attributable to various causes that can be categorised as acquired or congenital. Arrhythmias related to QT prolongation can result in clinical presentations, such as syncope and sudden cardiac death. The perioperative period presents a number of issues that may affect a patient's risk of developing polymorphic ventricular tachycardia or torsades de pointes. Although most patients may have an unremarkable perioperative course, some may have complications; this review article aims to help clinicians avoid potential complications, and to help them address treatment for perioperative issues that may occur...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29559999/recurrent-syncope-a-clue-in-amyloid-cardiomyopathy
#9
Julian A Marin-Acevedo, Catalina Sanchez-Alvarez, Ali A Alsaad, Ricardo J Pagán
Infiltrative cardiomyopathies include a variety of disorders that lead to myocardial thickening resulting in a constellation of clinical manifestations and eventually heart failure that could be the first clue to reach the diagnosis. Among the more described infiltrative diseases of the heart is amyloid cardiomyopathy. The disease usually presents with subtle, nonspecific symptoms. Herein, we illustrate a case of recurrent syncope as the initial presenting symptom for systemic amyloid with polyneuropathy and cardiomyopathy as a cause of syncope...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29557575/kounis-syndrome-a-disease-to-know-case-report-and-review-of-the-literature
#10
Edoardo Sciatti, Enrico Vizzardi, Dario S Cani, Assunta Castiello, Ivano Bonadei, Daria Savoldi, Marco Metra, Antonio D'Aloia
The case deals with an anaphylactoid reaction to intravenous ampicillin/sulbactam resulting in cardiogenic syncope and myocardial damage. Symptoms and ECG modifications promptly disappeared after corticosteroids administration. The Kounis syndrome is an acute coronary syndrome, including coronary spasm, acute myocardial infarction and stent thrombosis, resulting from an anaphylactic or anaphylactoid or allergic or hypersensitivity insult. First described in 1991, it can be caused by a lot of substances, particularly antibiotics...
March 16, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29557322/is-concussion-a-risk-factor-for-epilepsy
#11
Richard Wennberg, Carmen Hiploylee, Peter Tai, Charles H Tator
BACKGROUND: Epidemiologic studies have suggested that concussion, or mild traumatic brain injury (mTBI), is associated with a twofold or greater increase in relative risk for the development of post-traumatic epilepsy. To assess the clinical validity of these findings, we analyzed the incidence of epilepsy in a large cohort of post-concussion patients in whom concussion was strictly defined according to international guidelines. METHODS: A retrospective cohort study of 330 consecutive post-concussion patients followed by a single concussion specialist...
March 20, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29556152/atrial-septal-defect-as-unexpected-cause-of-pulmonary-artery-hypertension
#12
Rushi V Parikh, Jack Boyd, David P Lee, Ronald Witteles
Methamphetamine abuse is an increasingly prevalent cause of pulmonary artery hypertension in the United States. Conversely, an atrial septal defect rarely presents late as pulmonary artery hypertension. We present the case of a 44-year-old methamphetamine abuser who had a 3-month history of worsening fatigue and near-syncope. She had elevated cardiac enzyme levels and right-sided heart strain. Angiographic findings suggested methamphetamine-induced pulmonary artery hypertension; however, we later heard S2 irregularities that raised suspicion of an atrial septal defect...
February 2018: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29551725/cranio-cervical-junction-meningiomas-without-hydrocephalus-presenting-solely-with-syncope-report-of-two-cases
#13
Pierre-Olivier Champagne, Michel W Bojanowski
OBJECTIVE: To our knowledge, there have not been any reported cases of a meningioma of the cranio-cervical region presenting solely with syncope as its initial symptom. Only one case of meningioma presenting with syncope has been published, but it was associated with hydrocephalus. We report two cases of syncope caused by a cranio-cervical junction meningioma, with syncope being the sole presenting symptom and without hydrocephalus. We discuss the possible pathophysiology as well as the clinical relevance of this type of presentation...
March 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29550106/meta-analysis-of-t-peak-t-end-and-t-peak-t-end-qt-ratio-for-risk-stratification-in-congenital-long-qt-syndrome
#14
Gary Tse, Mengqi Gong, Lei Meng, Cheuk Wai Wong, Stamatis Georgopoulos, George Bazoukis, Martin C S Wong, Konstantinos P Letsas, Vassilios S Vassiliou, Yunlong Xia, Adrian M Baranchuk, Gan-Xin Yan, Tong Liu
BACKGROUND AND OBJECTIVES: Congenital long QT syndrome (LQTS) predisposes affected individuals to ventricular tachycardia/fibrillation (VF/VF), potentially resulting in sudden cardiac death. The Tpeak -Tend interval and the Tpeak -Tend /QT ratio, electrocardiographic markers of dispersion of ventricular repolarization, were proposed for risk stratification but their predictive values in LQTS have been controversial. A systematic review and meta-analysis was conducted to examine the value of Tpeak -Tend intervals and Tpeak -Tend /QT ratios in predicting arrhythmic and mortality outcomes in congenital LQTS...
March 6, 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29549928/catheter-ablation-of-bradyarrhythmia-from-the-beginning-to-the-future
#15
REVIEW
Tolga Aksu, Tumer Erdem Guler, Kivanc Yalin, Ferit Onur Mutluer, Kazim Serhan Ozcan, Leonardo Calò
Enhanced parasympathetic tone may cause sinus bradycardia or pauses, transient or permanent atrioventricular block, with resultant vasovagal syncope. A substantial portion of these patients may be highly symptomatic and refractory to the conventional therapies and may require cardiac pacemaker implantation. Cardioneuroablation is a little known technique for management of patients with excessive vagal activation based on radiofrequency catheter ablation of main parasympathetic autonomic ganglia around the heart...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29545958/acquired-coagulopathy-and-hemorrhage-secondary-to-subcutaneous-heparin-prophylaxis
#16
Maria Sunseri, Tania Ahuja, Tanya Wilcox, David Green
Unfractionated heparin and low-molecular-weight heparins are commonly used as thromboprophylaxis for hospitalized patients. Though generally considered safe at prophylactic doses, cases of catastrophic hemorrhage have been reported. The proposed mechanism involves bioaccumulation of heparin through saturation of the rapid-elimination pathway in its metabolism. We present an unusual case of an average-weight man with metastatic melanoma who suffered hemorrhage with syncope and end-organ damage while on prophylactic three times daily unfractionated heparin...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29540357/pulmonary-arterial-hypertension-pathogenesis-and-clinical-management
#17
REVIEW
Thenappan Thenappan, Mark L Ormiston, John J Ryan, Stephen L Archer
Pulmonary hypertension is defined as a resting mean pulmonary artery pressure of 25 mm Hg or above. This review deals with pulmonary arterial hypertension (PAH), a type of pulmonary hypertension that primarily affects the pulmonary vasculature. In PAH, the pulmonary vasculature is dynamically obstructed by vasoconstriction, structurally obstructed by adverse vascular remodeling, and pathologically non-compliant as a result of vascular fibrosis and stiffening. Many cell types are abnormal in PAH, including vascular cells (endothelial cells, smooth muscle cells, and fibroblasts) and inflammatory cells...
March 14, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29535880/pantoprazole-induced-delirium-review-of-a-case-and-associated-literature
#18
Anupriya Razdan, Ramaswamy Viswanathan, Alan Tusher
Background: Proton pump inhibitors (PPIs) are frequently prescribed antiulcer agents in hospitals and are shown to be safer than H-2 blockers. We present a case report of PPI-induced delirium, regarding which not much has been written in the literature. Case Report: We present a case of a 93-year-old woman with no known past psychiatric history, who was hospitalized for syncope workup and who developed delirium after a double dose of pantoprazole. Discussion: Very few reports of PPI-induced delirium exist in the literature...
2018: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/29532345/predictor-variables-of-abnormal-imaging-findings-of-syncope-in-the-emergency-department
#19
Kerem Ozturk, Esra Soylu, Cem Bilgin, Bahattin Hakyemez, Mufit Parlak
BACKGROUND: This study aimed to describe the pathological findings and to analyze clinical predictors of abnormal imaging findings in patients presenting to the emergency department (ED) with syncope. METHODS: The database was retrospectively reviewed for all patients who underwent cranial computed tomography (CT) or magnetic resonance imaging (MRI), having the symptom of syncope. Patients were included only if they were from the emergency department and excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor, or having a history of trauma...
March 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29528859/emerging-implications-of-genetic-testing-in-inherited-primary-arrhythmia-syndromes
#20
Babken Asatryan, Argelia Medeiros-Domingo
Inherited primary arrhythmia syndromes are genetically determined disorders of cardiac ion channels or ion channel macromolecular complexes usually associated with a higher risk of sudden cardiac death. These conditions have a very broad spectrum of clinical manifestations, ranging from an asymptomatic course to syncope, atrial and ventricular arrhythmias, and conduction disturbances, but may produce sudden infant death syndrome and unexplained sudden cardiac death in apparently healthy individuals. During the last 20 years, the evolving knowledge on the genetic basis of inherited arrhythmia syndromes has dramatically reshaped our understanding of these conditions and, consequently, had a great impact on patient care...
March 8, 2018: Cardiology in Review
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