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Syncope review

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https://www.readbyqxmd.com/read/29921622/diagnostic-yield-of-an-ambulatory-patch-monitor-in-patients-with-unexplained-syncope-after-initial-evaluation-in-the-emergency-department-the-patch-ed-study
#1
Matthew J Reed, Neil R Grubb, Christopher C Lang, Alasdair J Gray, Kirsty Simpson, Allan MacRaild, Christopher J Weir
OBJECTIVES: Diagnosing underlying arrhythmia in ED syncope patients remains problematic. This study investigates diagnostic yield, event prevalence, patient satisfaction and compliance, and influence on resource utilisation of an ambulatory patch monitor in unexplained ED syncope patients. METHODS: Prospective pilot study conducted in a single tertiary ED in Scotland between 17 November 2015 and 16 June 2017 with a historical unmatched comparator group. Patients 16 years or over presenting within 6 hours of unexplained syncope were fitted in the ED with an ambulatory patch ECG recorder (Zio XT monitor), which continuously records a single-lead ECG for up to 14 days...
June 19, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29904895/syncope-and-headache
#2
REVIEW
Ramesh K Khurana
PURPOSE OF REVIEW: We review the literature on co-occurrence of syncope and headache and share clinical experience. RECENT FINDINGS: Headache in relation to syncope has been the subject of recent interest. Orthostatic intolerance has an expanding spectrum with three well-defined entities: orthostatic hypotension (OH), neurally mediated hypotension (NMH), and postural tachycardia syndrome (PoTS). Syncope occurs in patients with OH as well as in patients with episodically occurring NMH...
June 15, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29904793/-tips-for-taking-the-medical-history-in-patients-with-syncope
#3
REVIEW
Carsten W Israel
Transient loss of consciousness represents one of the most frequent reasons for patients to present in the emergency room. Already at the very beginning, the diagnostic work-up is faced with fundamental questions: (1) Was it really a loss of consciousness? (2) Which department (neurology, cardiology, or others) should check the patient? (3) Is an in-hospital diagnostic work-up required? These questions can be answered from a meticulous patient history which needs to be adjusted to the individual case but also has to systematically go through a list of questions...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29899727/flecainide-induced-brugada-syndrome-in-a-patient-with-skeletal-muscle-sodium-channelopathy-a-case-report-with-critical-therapeutical-implications-and-review-of-the-literature
#4
Michele Cavalli, Barbara Fossati, Raffaele Vitale, Elisa Brigonzi, Vito A G Ricigliano, Lorenzo Saraceno, Rosanna Cardani, Carlo Pappone, Giovanni Meola
Skeletal muscle sodium channelopathies are a group of neuromuscular disorders associated with mutations in the SCN4A gene. Because principal sodium channel isoforms expressed in the skeletal muscles and the heart are distinct one from the other, this condition usually spares cardiac functioning. Nonetheless, evidence on a possible link between skeletal muscle and cardiac sodium channelopathies has emerged in recent years. To date, eight patients bearing pathogenetic mutations in the SCN4A gene and manifesting cardiac electrophysiological alterations have been reported in literature...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29876029/twiddler-s-syndrome-case-report-and-literature-review
#5
Elnur Tahirovic, Ilirijana Haxhibeqiri-Karabdic
Twiddler's syndrome is a rare complication after pacemaker implantation usually caused by patient manipulation with generator. We describe a case of 70-year-old female patient with pacemaker who was admitted to the neurological clinic with syncope and suspicion for neurological disease. After neurological diagnostic tests that were negative and consultation with a cardiologist, Twiddler's syndrome was diagnosed.
January 2018: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29873176/review-article-utility-of-troponin-after-syncope-a-systematic-review-and-meta-analysis
#6
REVIEW
Claire B Stark, De Villiers Smit, Biswadev Mitra
The role of serum troponin testing in patients presenting to the ED after syncope is unclear. The aim of this systematic review was to examine the practice and utility of troponin testing among patients presenting to the ED after syncope. We conducted a search of MEDLINE, Embase, Cochrane Library, Web of Science and Scopus databases from 1990 to February 2017 using keyword and subject headings for syncope and troponin testing. Design and results of the included studies are extracted. Studies were assessed for heterogeneity and the pooled proportion of measured troponin and positive troponin result described...
June 5, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29868128/cardiac-events-occurred-commonly-among-apparently-healthy-filipinos-with-the-brugada-ecg-pattern-in-the-lifecare-cohort
#7
Giselle G Gervacio, Jaime Alfonso Manalo Aherrera, Rody G Sy, Lauro L Abrahan Iv, Michael Joseph Agbayani, Felix Eduardo Punzalan, Elmer Jasper B Llanes, Paul Ferdinand M Reganit, Olivia T Sison, E Shyong Tai, Felicidad V Velandria, Allan Gumatay, Nina T Castillo-Carandang
Background: Brugada syndrome is the mechanism for sudden unexplained death. The Brugada ECG pattern is found in 2% of Filipinos. There is a knowledge gap on the clinical outcome of these individuals. The clinical profile and 5-year cardiac event rate of individuals with the Brugada ECG pattern were determined in this cohort. Methods: This is a sub-study of LIFECARE (Life Course Study in Cardiovascular Disease Epidemiology), a community based cohort enrolling healthy individuals 20 to 50 years old conducted in 2009-2010...
2018: Heart Asia
https://www.readbyqxmd.com/read/29860228/comparison-of-a-smartphone-based-ecg-recording-system-with-a-standard-cardiac-event-monitor-in-the-investigation-of-palpitations-in-children
#8
Mairi Macinnes, Nicholas Martin, Helen Fulton, Karen A McLeod
BACKGROUND: The AliveCor (Kardia) monitor attaches to a smartphone and allows a single-lead ECG to be recorded during symptoms. In 2016, we introduced the use of this smartphone device for investigating palpitations, without syncope, in children. The aim of our study was to review our experience with the smartphone device, comparing it with our previous standard conventional approach to cardiac event monitoring using the Cardiocall monitor, which uses skin electrodes and is given for a finite period...
June 2, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29784533/long-qt-syndrome-a-comprehensive-review-of-the-literature-and-current-evidence
#9
REVIEW
Syed Raza Shah, Ki Park
Long QT syndrome (LQT) represents a heterogeneous family of cardiac electrophysiologic disorders characterized by QT prolongation and T-wave abnormalities on the electrocardiogram. It is commonly associated with syncope, however, sudden cardiac death can occur due to torsades de pointes. LQT is a clinical diagnosis and should be suspected in individuals on the basis of clinical presentation, family history and electrocardiogram characteristics. Management is focused on the prevention of syncope and ultimately sudden death...
May 10, 2018: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29766477/-long-term-follow-up-of-psychogenic-pseudosyncope
#10
D P Saal, M J Overdijk, R D Thijs, I M van Vliet, J G van Dijk
BACKGROUND: Patients with psychogenic pseudosyncope (PPS) are frequently seen by neurologists and psychiatrists. As of yet, there has been no follow-up study of patients with PPS after communicating the diagnosis. AIM: To determine the outcome of patients with psychogenic pseudosyncope (PPS) after communicatingthe diagnosis. METHOD: A retrospective cohort study of patients with PPS referred to a tertiary referral center for syncope from 2007 to 2015...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29766267/-syncopes-and-channelopathies
#11
REVIEW
Johanna Müller-Leisse, Christos Zormpas, Thorben König, David Duncker, Christian Veltmann
Syncope can be the first manifestation of cardiac channelopathies, namely Brugada syndrome, long QT syndrome, short QT syndrome and catecholaminergic polymorphic ventricular tachycardia (CPVT). Patients affected by these rare diseases are at increased risk for sudden cardiac death due to ventricular tachyarrhythmias and require specific therapy and follow-up. As syncope is common in the general population, only few cases are caused by an underlying channelopathy. Nevertheless, the diagnosis should be considered in young patients with structurally normal hearts, especially if the history of syncope is typical for an arrhythmogenic cause, in the presence of characteristic echocardiogram (ECG) patterns, and if there is a family history of channelopathies or sudden cardiac death...
May 15, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29760850/predictors-of-short-term-outcomes-after-syncope-a-systematic-review-and-meta-analysis
#12
Thomas A Gibson, Robert E Weiss, Benjamin C Sun
Introduction: We performed a systematic review and meta-analysis to identify predictors of serious clinical outcomes after an acute-care evaluation for syncope. Methods: We identified studies that assessed for predictors of short-term (≤30 days) serious clinical events after an emergency department (ED) visit for syncope. We performed a MEDLINE search (January 1, 1990 - July 1, 2017) and reviewed reference lists of retrieved articles. The primary outcome was the occurrence of a serious clinical event (composite of mortality, arrhythmia, ischemic or structural heart disease, major bleed, or neurovascular event) within 30 days...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758173/lack-of-genotype-phenotype-correlation-in-families-who-had-brugada-syndrome-and-sudden-arrhythmic-death-syndrome-with-reported-pathogenic-scn1b-variants
#13
Belinda Gray, Can Hasdemir, Jodie Ingles, Takeshi Aiba, Naomasa Makita, Vincent Probst, Arthur A M Wilde, Ruth Newbury-Ecob, Mary N Sheppard, Christopher Semsarian, Raymond W Sy, Elijah R Behr
BACKGROUND: There is limited evidence that Brugada syndrome (BrS) is due to SCN1B variants (BrS5). This gene may be inappropriately included in routine genetic testing panels for BrS or sudden arrhythmic death syndrome (SADS). OBJECTIVE: We sought to characterize the genotype-phenotype correlation in families who had BrS and SADS with reportedly pathogenic SCN1B variants and to review their pathogenicity. METHODS: Families with BrS and SADS were assessed from 6 inherited arrhythmia centers worldwide, and a comprehensive literature review was performed...
May 3, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29701392/cardiac-fibroelastoma-10-year-experience
#14
Jorge Pinheiro Santos, Nuno Banazol, António Cruz Tomás, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Papillary fibroelastoma is one of the most common types of primary cardiac tumour. Though a rare pathology, its importance relates to its form of presentation, with stroke and sudden death, and the questions regarding its management. OBJECTIVES: To review the casuistic of cardiac tumours in our service, in special the papillary fibroelastomas. METHODS: clinical case series overviewing the period from 1st January 2008 to 30th September 2017...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696347/syncope-and-bundle-branch-block-diagnostic-approach
#15
REVIEW
Angel Moya, Nuria Rivas-Gandara, Jordi Perez-Rodón, Jaume Franciso-Pascual, Alba Santos-Ortega, Patricia Fumero, Ivo Roca-Luque
Syncope and bundle branch block are reviewed, addressing their specific clinical characteristics, natural history, initial diagnostic approach and the role and limitations of different diagnostic tests with a special focus on electrophysiological studies and implantable loop recorders. A critical review of the different published strategies to be followed in these patients is made and finally an algorithm of how to manage these patients is proposed.
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29696346/orthostatic-intolerance-and-postural-tachycardia-syndrome-new-insights-into-pathophysiology-and-treatment
#16
REVIEW
Mohammed Ruzieh, Blair P Grubb
Orthostatic intolerance is characterized by symptoms of light-headedness or syncope that is provoked upon standing or in an upright posture. It is most commonly caused by postural orthostatic tachycardia syndrome (POTS) or orthostatic hypotension (OH). Its pathophysiology is complex and commonly involves abnormal autonomic nervous system regulation, autoimmunity, a hyperadrenergic state, and hypovolemia. This article reviews the pathophysiology underlying orthostatic intolerance, as well as the current treatment available...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29688316/diagnostic-and-therapeutic-strategies-for-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-patient
#17
Weijia Wang, Cynthia A James, Hugh Calkins
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a rare inherited heart muscle disease characterized by ventricular tachyarrhythmia, predominant right ventricular dysfunction, and sudden cardiac death. Its pathophysiology involves close interaction between genetic mutations and exposure to physical activity. Mutations in genes encoding desmosomal protein are the most common genetic basis. Genetic testing plays important roles in diagnosis and screening of family members. Syncope, palpitation, and lightheadedness are the most common symptoms...
April 23, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29672598/long-qt-molecular-autopsy-in-sudden-unexplained-death-in-the-young-1-40-years-old-lessons-learnt-from-an-eight-year-experience-in-new-zealand
#18
Luciana Marcondes, Jackie Crawford, Nikki Earle, Warren Smith, Ian Hayes, Paul Morrow, Tom Donoghue, Amanda Graham, Donald Love, Jonathan R Skinner
BACKGROUND: To review long QT syndrome molecular autopsy results in sudden unexplained death in young (SUDY) between 2006 and 2013 in New Zealand. METHODS: Audit of the LQTS molecular autopsy results, cardiac investigations and family screening data from gene-positive families. RESULTS: During the study period, 365 SUDY cases were referred for molecular autopsy. 128 cases (35%) underwent LQTS genetic testing. 31 likely pathogenic variants were identified in 27 cases (21%); SCN5A (14/31, 45%), KCNH2 (7/31, 22%), KCNQ1 (4/31, 13%), KCNE2 (3/31, 10%), KCNE1 (2/31, 7%), KCNJ2 (1/31, 3%)...
2018: PloS One
https://www.readbyqxmd.com/read/29666096/devil-is-in-the-detail
#19
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
#20
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
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