Postural syncope: mechanisms and management

Postural syncope is a transient loss of consciousness secondary to a reduction in cerebral blood flow and is typically precipitated by standing. It is the commonest cause of recurrent transient loss of consciousness. Recurrent unexplained postural syncope is most often due to one of the five disorde...

Full description

Saved in:
Bibliographic Details
Published inMedical journal of Australia Vol. 187; no. 5; p. 299
Main Authors Vaddadi, Gautam, Lambert, Elisabeth, Corcoran, Susan J, Esler, Murray D
Format Journal Article
LanguageEnglish
Published Australia 03.09.2007
Subjects
Algorithms
Electrocardiography
Humans
Syncope - diagnosis
Syncope - etiology
Syncope - physiopathology
Syncope - therapy
Tilt-Table Test
Online AccessGet more information

Cover

More Information
Summary:Postural syncope is a transient loss of consciousness secondary to a reduction in cerebral blood flow and is typically precipitated by standing. It is the commonest cause of recurrent transient loss of consciousness. Recurrent unexplained postural syncope is most often due to one of the five disorders of circulatory control: vasovagal syncope, postural tachycardia syndrome, chronic autonomic failure, initial orthostatic hypotension, or persistently low supine systolic blood pressure. Failure to identify the underlying cause of postural syncope can result in ongoing morbidity, impaired quality of life and high health care costs. With a detailed history, examination, blood pressure assessment and electrocardiography, most disorders of circulatory control can be diagnosed. In difficult cases, analysis of sympathetic nervous system and circulatory responses during head-up tilting can aid diagnosis. Treatment is challenging and compounded by a lack of evidence. Most patients can be managed in an outpatient setting, and hospital admission or emergency department assessment is rarely warranted.
ISSN:0025-729X
DOI:10.5694/j.1326-5377.2007.tb01248.x