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Id: lil-458207
Autor: Macatrão-Costa, Milena Frota; Hachul, Denise.
Título: Diagnóstico de síncope / Diagnosing syncope
Fonte: Rev. Soc. Cardiol. Estado de Säo Paulo;17(1):1-10, jan.-mar. 2007. tab, ilus.
Idioma: pt.
Resumo: Síncope é um sintoma multifatorial de dificil diagnóstico. O objetivo desta revisão é abordar o diagnóstico diferencial das síncopes, cujo prognóstico é variável, incluíndo pacientes com alto risco de morte súbita e indivíduos com grande comprometimento da qualidade de vida. A abordagem do paciente com síncope, realizada por profissionais especializados e organizados em Unidades de Investigação de Síncope, muito tem facilitado o esclarecimento etiológico desse sintoma, diminuindo o tempo, os custos e a necessidade de internações.

Syncope, a symptom with multiple possible etiologies is frequently difficult to diagnose. The aim of this manuscript is to review the differential diagnosis of syncope, how to identify high risk patients and also the benign causes that compromise quality of life. The management of patients with syncope performed by specialists organized in Syncope Units is a new tool to facilitate the diagnosis, decreasing hospital admissions and promoting a better cost effectiveness.
Descritores: Síncope/complicações
Síncope/diagnóstico
-Fatores de Risco
Qualidade de Vida/psicologia
Limites: Humanos
Masculino
Feminino
Responsável: BR44.1 - Serviço de Biblioteca, Documentação Científica e Didática Prof. Dr. Luiz Venere Décourt


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Id: biblio-1289267
Autor: Sánchez, Alejandro Olaya; Camargo, Miguel Tejeda; Cárcamo, Luis; Vargas, Diana; Díaz, Andrés; Mora, Guillermo.
Título: Desenlaces a un año en pacientes con síncope de alto y bajo riesgo / One-year outcomes in patients with high-risk and low-risk syncope
Fonte: Rev. colomb. cardiol;27(6):517-525, nov.-dic. 2020. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: El síncope es un síntoma complejo de evaluar, que además representa un reto diagnóstico; la estratificación inadecuada del riesgo de los pacientes puede conllevar mal uso de los recursos en salud y aumentar así el costo derivado de la atención. Objetivo: Comparar la incidencia de desenlaces a un año en pacientes con síncope de alto y bajo riesgo en cuatro hospitales de Bogotá. Metodología: Estudio de cohorte retrospectiva, en el que se incluyeron pacientes mayores de 18 años que consultaron a urgencias por síncope, y que fueron seguidos desde febrero de 2013 hasta julio de 2015. Fueron clasificados en bajo y alto riesgo según la escala de Martin et al. Se hizo seguimiento telefónico para evaluar los desenlaces a un año. Resultados: Los pacientes de alto riesgo tienen mayor frecuencia de mortalidad, recurrencia del síncope, requerimiento de hospitalización, eventos neurológicos y necesidad de intervención cardiovascular. La mortalidad global está alrededor del 6% y en el subgrupo de pacientes de mayor puntaje (4 puntos) asciende al 16,6%. La mayoría de eventos se presentaron en los primeros 6 meses de seguimiento. La mortalidad y la necesidad de intervención cardiovascular tuvieron un incremento de su frecuencia a medida que aumentó el puntaje de la escala. Conclusión: Los pacientes clasificados en alto riesgo según la escala de Martin et al. tienen mayor frecuencia de desenlaces adversos a un año de seguimiento, y por tanto podrían beneficiarse de un estudio más amplio y expedito de la causa del síncope.

Abstract Introduction: Syncope is a complex symptom to assess, and is a diagnostic challenge. The inadequate risk stratification can lead to the inappropriate use of health resources and to an increase in the costs arising from the care. Objective: To compare the outcomes at one year in patients with high and low risk syncope in four Bogota hospitals. Material and method: A retrospective cohort study was conducted that included patients over 18 years-old that were seen in the Emergency Department due to a syncope. They were followed-up from February 2013 until July 2015. They were classified into low and high risk according to the score on the scale of Martin et al. At one year, a telephone call follow-up was made to assess the outcomes. Results: The high risk patients had higher rates of mortality and recurrence of syncope, required more hospital admissions, had more neurological events, and a greater need for cardiac intervention. The overall mortality was 6%, and in sub-group of patients with a higher score (4 points) it increased to 16.6%. The majority of events occurred in the first 6 months of follow-up. The mortality and the need for cardiovascular intervention were associated with the increase in the score on the scale. Conclusion: Patients classified as high risk according to the scale of Martin et al. are more likely to have adverse outcomes at one year of follow-up, and thus could benefit from a larger study and directed at the cause of the syncope.
Descritores: Síncope
-Recidiva
Risco
Mortalidade
Emergências
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: CO369.9 - SCC - Sociedad Colombiana de Cardiologia y Cirugía Cardiovascular


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Id: biblio-1289277
Autor: Pérez Díaz, Pedro; Jurado Román, Alfonso; Moreno Reig, Álvaro; Jiménez Díaz, Javier; Rayo Gutiérrez, Manuel; Frías García, Raquel; Maseda Uriza, Ramón; Requena Ibáñez, Juan Antonio.
Título: Taquicardia ventricular polimórfica y miocardio no compactado, ¿una nueva variante genética? / Polymorphic ventricular tachycardia and non-compacted myocardium: A new genetic variant?
Fonte: Rev. colomb. cardiol;27(6):597-601, nov.-dic. 2020. graf.
Idioma: es.
Resumo: Resumen La taquicardia ventricular polimórfica catecolaminérgica es una enfermedad caracterizada por arritmias ventriculares desencadenadas por estrés o actividad física. Existen casos descritos de taquicardia ventricular polimórfica catecolaminérgica asociada a ventrículo izquierdo no compactado, en relación con mutaciones del gen RYR2 localizadas en el exón 3. Se expone el caso clínico de una paciente joven que debutó con clínica de síncopes recurrentes asociados a estrés físico o emocional. En el estudio posterior se descubrió taquicardia ventricular polimórfica catecolaminérgica, con áreas de miocardio no compactado y una nueva variante genética posiblemente asociada a la enfermedad.

Abstract Catecholaminergic polymorphic ventricular tachycardia is disease characterised by ventricular arrhythmias triggered by stress or physical activity. There are some cases of catecholaminergic polymorphic ventricular tachycardia described that are associated with non-compacted left ventricle in relation to mutations of the RYR2 gene located in exon 3. A case is presented of a young patient in whom the clinical signs started with recurrent syncope associated with physical or emotional stress. In the subsequent study, catecholaminergic polymorphic ventricular tachycardia was discovered, with areas of non-compacted myocardium and new genetic variant possibly associated with the disease.
Descritores: Taquicardia Ventricular
-Síncope
Ventrículos do Coração
Cardiomiopatias
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CO369.9 - SCC - Sociedad Colombiana de Cardiologia y Cirugía Cardiovascular


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Id: biblio-1023248
Autor: Bastos, Mauricio Gonczy Nunes; Macedo, Thiago Andrade de; Alves, Fabio Quartieri; Jardim, Leandro de Oliveira; Barros e Silva, Pedro Gabriel Melo de; Sampaio, Marcio Campos; Teixeira, José Carlos Garcia; Furlan, Valter.
Título: Cardiomiopatia periparto associada à síndrome do QT longo e síncope por taquicardia ventricular polimórfica: relato de caso / Peripartum cardiomyopathy associated with long QT syndrome and polymorphic ventricular tachycardia syncope: a case report
Fonte: Rev. Soc. Cardiol. Estado de Säo Paulo;29(3 Supl):320-323, jul.-set. 2019. ilus.
Idioma: en; pt.
Resumo: A cardiomiopatia periparto é uma causa rara de insuficiência cardíaca no período entre o último mês de gestação e os cinco meses após o parto. A síndrome do QT longo caracteriza-se pelo atraso da repolarização ventricular e pode se manifestar com síncope e morte súbita devido a um tipo de taquicardia ventricular polimórfica conhecida como torsades de pointes. Descrição do caso: J.S., 26 anos, sexo feminino, natural e procedente de São Paulo. Paciente puérpera - 40º dia (G3P3A0), procurou o pronto-socorro com queixa de síncope durante amamentação e dispneia em moderados esforços. Durante a avaliação no PS, evoluiu para desconforto torácico e agitação psicomotora, sendo notada taquicardia ventricular não sustentada no monitor cardíaco ( torsades de pointes), que foi controlada com cardioversão elétrica e sulfato de magnésio intravenoso. O eletrocardiograma mostrou ritmo sinusal, alteração difusa da repolarização ventricular e intervalo QTc de 580 ms. O ecocardiograma mostrou disfunção sistólica moderada, com fração de ejeção do ventrículo esquerdo de 43% à custa de hipocinesia difusa. Após avaliação da equipe de arritmologia chegou-se ao diagnóstico de cardiomiopatia periparto associado à síndrome do QT longo. Foi iniciado tratamento otimizado para insuficiência cardíaca e implantado cardiodesfibrilador por causa de episódios recorrentes de arritmia durante a internação. Discussão: A cardiomiopatia periparto é uma doença rara, porém, tem taxa de mortalidade elevada, entre 18% e 56%. A paciente descrita satisfez os quatro critérios para o diagnóstico: sintomas de insuficiência cardíaca nos primeiros 5 meses depois do parto, ausência de cardiomiopatia prévia, etiologia desconhecida e disfunção sistólica com FEVE < 45%. A síndrome do QT longo é uma doença genética de apresentações variáveis. Os fatores que desencadeiam as taquiarritmias são situações de instabilidade elétrica por hiperatividade do sistema simpático e também situações raras, como a cardiomiopatia periparto. Em casos de arritmias ventriculares graves, o tratamento é o implante de cardiodesfibrilador. Conclusão: A associação da cardiomiopatia periparto com a síndrome do QT longo é rara. A gravidade associada a essas condições torna importante o diagnóstico precoce e tratamento imediato pelo potencial risco de morte associado a ambas as condições clínicas

Peripartum cardiomyopathy is a rare cause of heart failure during the period between the last month of pregnancy and five months after delivery. Long QT syndrome is characterized by a delay in ventricular repolarization and may manifest with syncope and sudden death due to a type of polymorphic ventricular tachycardia known as torsades de pointes. Case description: J.S., 26-years-old, female, born and residing in São Paulo, Puerperal - 40th day (G3C3A0), went to the emergency room complaining of syncope during breastfeeding and dyspnea on moderate exertion. During evaluation in the ER, the patient developed thoracic discomfort and psychomotor agitation, with non-sustained ventricular tachycardia on the cardiac monitor (torsades de pointes), which was controlled with electrical cardioversion and intravenous magnesium sulfate. The electrocardiogram showed sinus rhythm, diffuse alteration of ventricular repolarization and QTc interval of 580 ms. The echocardiogram showed moderate systolic dysfunction, with a left ventricular ejection fraction of 43% influenced by diffuse hypokinesia. After evaluation by the arrhythmology team, the diagnosis of peripartum cardiomyopathy associated with long QT syndrome was made. Optimized treatment for heart failure was initiated and a cardioverter-defibrillator was implanted due to recurrent episodes of arrhythmia during hospitalization. Discussion: Peripartum cardiomyopathy is a rare disease, but it has a high mortality rate, between 18% and 56%. The patient described met the 4 diagnostic criteria: symptoms of heart failure in the first 5 months after delivery, absence of prior cardiomyopathy, unknown etiology, and systolic dysfunction with LVEF<45%. Long QT syndrome is a genetic disease of varying presentations. The factors that trigger the tachyarrhythmias are situations of electrical instability due to sympathetic system hyperactivity and rare situations, such as peripartum cardiomyopathy. In cases of severe ventricular arrhythmias, the treatment is a cardioverter-defibrillator implant. Conclusion: The association of peripartum cardiomyopathy with long QT syndrome is rare. The severity associated with these conditions points out early diagnosis and immediate treatment important because of the potential risk of death associated with both clinical conditions
Descritores: Síndrome do QT Longo
Taquicardia Ventricular
Período Periparto
Cardiomiopatias/diagnóstico
-Síncope
Fatores de Risco
Torsades de Pointes
Eletrocardiografia/métodos
Frequência Cardíaca
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: BR44.1 - Serviço de Biblioteca, Documentação Científica e Didática Prof. Dr. Luiz Venere Décourt


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Id: lil-755566
Autor: Méndez, Arnold; Rojas, Ingrid Tatiana; Amarís, Óscar Ernesto; Mora, Guillermo.
Título: Rendimiento pronóstico de reglas de decisión clínica en síncope Un estudio piloto / Prognostic performance of clinical decision rules in syncope A pilot study
Fonte: Acta méd. colomb;40(1):36-44, ene.-mar. 2015. ilus, tab.
Idioma: es.
Resumo: Objetivo: desarrollar un estudio piloto de factibilidad de comparación del rendimiento pronóstico de las reglas de decisión clínica en pacientes con síncope. Objetivo secundario: evaluar el rendimiento pronóstico de las reglas de decisión OESIL (Osservatorio Epidemiologico sulla Síncope nel Lazio), EGSYS (European Guidelines in Syncope Study), SFSR (San Francisco Syncope Rule) y su aplicación con los Ottawa Electrocardiographic Criteria (SFSR+Ottawa), en predicción de mortalidad por cualquier causa y desenlaces cardiovasculares y no cardiovasculares mayores a siete y 30 días. Métodos: estudio observacional, analítico, prospectivo, tipo longitudinal, de no intervención, con muestreo por conveniencia. Se incluyeron pacientes >18 años de edad admitidos a urgencias con síncope menor o igual a 48 horas de evolución. Se compararon las reglas mediante curvas ROC y sensibilidad, especificidad, VPP y VPN para mortalidad y desenlaces mayores a siete y 30 días. Resultados: se incluyeron 44 pacientes durante un periodo de siete meses, hospitalizándose el100%. El análisis ROC mostró una AUC para SFSR+Ottawa para mortalidad y/o desenlaces mayores a siete días de 0.76 (IC 95% 0.49-0.82) y 30 días 0.76 (IC 95% 0.49-0.82), con sensibilidad de 86 y 84% y especificidad de 45 y 47% a siete y 30 días respectivamente. Conclusiones: es factible realizar un estudio de comparación de rendimiento pronóstico de reglas de decisión clínica de síncope en Colombia. La comparación realizada, sugiere un mejor desempeño de SFSR si se aplica con los criterios electrocardiográficos de Ottawa (SFSR+Ottawa) para la predicción de desenlaces a corto plazo. (Acta Med Colomb 2015; 40: 36-44).

Objective: to develop a feasibility pilot study comparing the prognostic performance of clinical decision rules in patients with syncope. Secondary objective: To assess the prognostic performance of OESIL (Osservatorio sulla Epidemiologico Sincope nel Lazio) decision rules, EGSYS (European Guidelines in Syncope Study), SFSR (San Francisco Syncope Rule) and its application to the Ottawa Electrocardiographic Criteria (SFSR + Ottawa) in predicting all-cause mortality and cardiovascular and non-cardiovascular outcomes longer than seven and 30 days. Methods: an observational, analytical, prospective, longitudinal, non-interventional study with convenience sampling. Patients >18 years of age admitted to the emergency room less than or equal to 48 hours after onset of syncope were included. Rules were compared by using ROC curves and sensitivity, specificity, PPV and NPV for mortality and major outcomes to seven and 30 days. Results: 44 patients were included over a period of seven months. 100% were hospitalized. ROC analysis showed an AUC for SFSR + Ottawa for mortality and / or major outcomes to 7 days of 0.76 (95% CI 0.49 to 0.82) and 30 days 0.76 (95% CI 0.49-0.82) with sensitivity of 86 and 84% and specificity of 45 and 47% for seven and 30 days respectively. Conclusions: it is feasible to conduct a comparison study of prognostic performance of clinical decision rules of syncope in Colombia. The comparison realized suggests a better performance of SFSR if applied with electrocardiographic criteria of Ottawa (SFSR + Ottawa) for predicting outcomes in the short term. (Acta Med Colomb 2015; 40: 36-44).
Descritores: Síncope
-Curva ROC
Sensibilidade e Especificidade
Emergências
Regras de Decisão Clínica
Limites: Humanos
Masculino
Feminino
Adulto
Responsável: CO70 - Asociación Colombiana de Medicina Interna


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Id: biblio-1149831
Autor: Velásquez-Torres, Alejandro; Palacios Sánchez, Leonardo.
Título: Consideraciones sobre las condiciones neuropsiquiátricas del Quijote de la Mancha / Considerations about the Neuropsychiatry Conditions of Quixote of La Mancha
Fonte: Rev. colomb. psiquiatr;49(3):216-219, jul.-set. 2020.
Idioma: es.
Resumo: RESUMEN Don Quijote de la Mancha, el pintoresco personaje creado por Miguel de Cervantes Saavedra en su obra inmortal El Ingenioso Hidalgo Don Quijote de la Mancha, presenta varias condiciones neuropsiquiátricas que incluyen tremor, trastornos del sueño, síntomas neuropsiquiátricos, síncope, trastornos de la percepción y traumatismo craneoencefálico. A lo largo de la obra, se presentan episodios en los que se hacen evidentes los diferentes trastornos mencionados. El artículo hace un recuento de ellos a través de la novela y un análisis a la luz de los conocimientos actuales sobre dichas condiciones.

ABSTRACT Don Quixote of La Mancha, the picturesque character created by Miguel de Cervantes Saavedra in his immortal book The Ingenious Nobleman Sir Quixote of La Mancha, presents several neuropsychiatric conditions, including tremor, sleep disturbances, neuropsychiatric symptoms, syncope, perception disorders and traumatic brain injury. Throughout the masterpiece, there are episodes where the aforementioned disorders are evident. This paper makes a list of them and analyses them in the light of the current knowledge of those conditions.
Descritores: Transtornos da Percepção
Neuropsiquiatria
-Sono
Transtornos do Sono-Vigília
Síncope
Discriminação Psicológica
Limites: Humanos
Responsável: CO78 - Asociación Colombiana de Psiquiatría


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Id: biblio-1278148
Autor: Valencia-Álvarez, Julián David; Drovo Turbay, Carolina; Mora-Pabón, Guillermo.
Título: Características operativas de la regla de predicción STePS, para desenlaces graves a corto plazo en pacientes con síncope / Operative characteristics of the STePS prediction rule for short-term serious outcomes in patients with syncope
Fonte: Acta méd. colomb;46(1):1-6, ene.-mar. 2021. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: el síncope es una entidad clínica frecuente en urgencias con un pronóstico variable que depende de su etiología. El estudio STePS identificó cuatro variables que se asociaron independientemente con desenlaces graves a 10 días. El objetivo del estudio fue evaluar su rendimiento en una población de pacientes que acuden al servicio de urgencias por síncope. Metodología: estudio prospectivo observacional de pacientes que consultaron a urgencias del Hospital Universitario Clínica San Rafael con diagnóstico de síncope. Se realizó un análisis descriptivo de las variables demográficas y clínicas de la población, y un análisis comparativo según el ingreso o no a UCI. Se analizaron las variables cualitativas y cuantitativas por medio de prueba de chi cuadrado y t student respectivamente. Las características operativas de la regla STePS fueron evaluadas en una gráfica considerándose como aceptable un área bajo la curva (AUC) mayor a 0.8 y como óptima un AUC mayor a 0.9. Resultados: se incluyeron 98 pacientes. El rendimiento de la regla de predicción STePS fue AUC-ROC 0.64 (IC95%; 0.53-0.75). Sólo el electrocardiograma anormal (OR 13.98, IC 95% 1.29151.9) y trauma concomitante (OR 5.22, IC 95% 1.20-22.67) demostraron ser factores de riesgo para desenlaces graves a 10 días. Se identificaron factores prevalentes en la población con ingreso a UCI: edad >65 años (p=0.02), antecedente de falla cardiaca (p=0.047), enfermedad renal crónica (p=0.002) y cardiopatía (p=0.01). Conclusión: la regla de predicción STePS no tuvo un rendimiento favorable para predicción de desenlaces graves a 10 días del evento sincopal en esta población estudiada.

Abstract Introduction: syncope is a common clinical condition in the emergency room with a variable prognosis depending on its etiology. The STePS study identified four variables which were independently related to serious outcomes within 10 days. The objective of the study was to evaluate its performance in a population of patients seen in the emergency room for syncope. Methods: a prospective observational study of patients seen in the emergency room of the Hospital Universitario Clínica San Rafael with a diagnosis of syncope. A descriptive analysis of the population's demographic and clinical variables was conducted, along with a comparative analysis according to admission or non-admission to the ICU. Qualitative and quantitative variables were analyzed using Chi-square or Student's t test, respectively. The operative characteristics of the STePS rule were evaluated in a graph, with an area under the curve (AUC) greater than 0.8 considered to be acceptable, and greater than 0.9 considered to be optimal. Results: Ninety-eight patients were included. The performance of the STePS prediction rule was AUC-ROC 0.64 (95% CI; 0.53-0.75). Only an abnormal electrocardiogram (OR 13.98, 95% CI 1.29-151.9) and concomitant trauma (OR 5.22, 95% CI 1.20-22.67) proved to be risk factors for serious outcomes within 10 days. Prevalent factors in the population admitted to the ICU were: age >65 years (p=0.02), a history of heart failure (p=0.047), chronic kidney disease (p=0.002) and heart disease (p=0.01). Conclusion: the STePS prediction rule did not perform favorably for predicting serious outcomes within 10 days of the syncopal event in this study population.
Descritores: Síncope
-Ferimentos e Lesões
Fatores de Risco
Níveis Máximos Permitidos
Emergências
Previsões
Cardiopatias
Limites: Humanos
Masculino
Feminino
Idoso
Responsável: CO70 - Asociación Colombiana de Medicina Interna


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Id: biblio-1252312
Autor: Penagos-Guio, Karen Dayanna; Sandoval-Montealegre, Alejandra; Llano-Bautista, Diana Goretty; Galindo-Martínez, José Julián; Reyes-Ortiz, Leonardo José; Tafurt-Cardona, Yaliana.
Título: Detección de síncope vasovagal con adaptación de la Escala de Calgary en estudiantes universitarios colombianos / Using a Calgary Scale adaptation to detect vasovagal syncope in Colombian university students
Fonte: Univ. salud;23(2):92-99, mayo-ago. 2021. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: El síncope vasovagal tiene una incidencia entre 10% y 19% en la población general, el primer episodio suele aparecer en la juventud. Objetivo: Estimar la prevalencia de síncope vasovagal en una población universitaria del sur de Colombia, utilizando una adaptación de la Escala de Calgary como cuestionario diagnóstico. Materiales y métodos: Después de la firma voluntaria del consentimiento informado, los estudiantes fueron entrevistados y se les aplicó la Escala de Calgary. Posteriormente, se realizó un cuestionario de seguimiento a los participantes positivos. Resultados: Participaron 280 estudiantes, el 17% obtuvo un puntaje positivo para síncope vasovagal. La edad media fue 21,45±5,18; con mayor positividad para el género femenino. En el seguimiento, el 10% de los positivos, consultó a urgencias por pérdida de conciencia, 4% fue ingresado a hospitalización y 10% presentó lesiones secundarias. Conclusiones: Un número representativo de participantes fue positivo en la Escala de Calgary, ninguno de ellos había recibido diagnóstico de síncope neuralmente mediado, pese a haber consultado a urgencias y/o presentar lesiones secundarias por pérdida de conciencia. Incluir la Escala de Calgary en la evaluación inicial del paciente consultante por pérdida de conciencia, podría ayudar al diagnóstico temprano de síncope vasovagal.

Abstract Introduction: Vasovagal syncope has an incidence between 10% and 19% in the general population, whose first episodes appear in youth. Objective: To estimate the prevalence of vasovagal syncope in a university student population from the southern Colombia, using a diagnostic questionnaire adapted from the Calgary Scale. Materials and methods: After voluntary signing of the informed consent form, students were surveyed through the Calgary Scale, and a subsequent follow-up questionnaire was conducted on positive participants. Results: 280 students participated in the study and 17% of them obtained a positive score for vasovagal syncope, being positive female participants the largest group. The mean age of participants was 21.45±5.18 years. At the follow-up, 10% of the positive cases had sought out treatment in emergency rooms because of consciousness loss, 4% were hospitalized, and 10% had secondary injuries. Conclusions: Even though an important number of patients was positive on the Calgary Scale, none of them had been diagnosed with neutrally mediated syncope, despite being treated in emergency rooms and/or presenting secondary lesions due to consciousness loss. The use of the Calgary Scale during the assessment of patients being treated for consciousness loss could help to early diagnose vasovagal syncope.
Descritores: Síncope Vasovagal
-Síncope
Inquéritos e Questionários
Inquéritos Epidemiológicos
Responsável: CO146.1 - CESUN - Centro de Estudios en Salud


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Id: biblio-1045853
Autor: Williams-Phillips, S; Tulloch-Reid, M.
Título: Syncope: Clinical Presentation of Bronchial Asthma / Síncope: presentación clínica del asma bronquial
Fonte: West Indian med. j;67(3):279-282, July-Sept. 2018.
Idioma: en.
Resumo: ABSTRACT Syncope, first described by Hippocrates, can be differentiated into neurological, cardiac and non-cardiac in origin, and this differentiation is of prognostic significance. The cardiac causes of syncope, which can be structural, electrophysiological or infectious, have a relatively poor prognosis and are associated with ethnicity, geographic location and sudden cardiac death. In decreasing frequency, the cardiac causes are hypertrophic cardiomyopathy, anomalous coronary arteries, Marfan Syndrome and dilated cardiomyopathy. Electrophysiological causes include supraventricular causes, Wolf-Parkinson-White syndrome, ion channelopathies, long QT syndrome and Brugada syndrome. The index case with bronchial asthma presented with syncope. There is an increased morbidity and mortality of this specific group of patients, if undiagnosed and not optimally treated; hence the need for a high index of suspicion and early diagnosis, after exclusion of cardiac and more common neurological causes. This is the first documented case of syncope secondary to bronchial asthma in an Afro-Caribbean.

RESUMEN El síncope, primeramente, descrito por Hipócrates, se puede clasificar como neurológico, cardíaco y no cardíaco atendiendo a su origen, y esta diferenciación tiene importancia pronóstica. Las causas cardíacas del síncope - que pueden ser estructurales, electrofisiológicas o infecciosas - tienen un pronóstico relativamente pobre y se asocian con la etnicidad, la localización geográfica y la muerte cardiaca repentina. En frecuencia decreciente, las causas cardíacas son la cardiomiopatía hipertrófica, las arterias coronarias anómalas, el síndrome de Marfan y la cardiomiopatía dilatada. Las causas electrofisiológicas incluyen las causas supraventriculares, el síndrome de Wolf-Parkinson-White, las canalopatías iónicas, el síndrome de QT largo, y el síndrome de Brugada. El caso índice con asma bronquial se presentó con síncope. Hay una mayor morbilidad y mortalidad de este grupo específico de pacientes, si no se diagnostica y no se trata de forma óptima. De ahí, la necesidad de un alto índice de suspicacia y diagnóstico temprano, luego de la exclusión de las causas cardíacas y las causas neurológicas más comunes. Éste es el primer caso documentado de síncope secundario al asma bronquial en un afrocaribeño.
Descritores: Asma/complicações
Asma/diagnóstico
Síncope/etiologia
-Índice de Gravidade de Doença
Teste de Esforço
Limites: Humanos
Feminino
Criança
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-1155788
Autor: Rocha, Eduardo Arrais; Cunha, Gisele Schineider; Tavares, Aline Bezerra; Viana Júnior, Antônio Brazil; Quidute, Ana Rosa Pinto; Pereira, Francisca Tatiana Moreira; Monteiro, Marcelo de Paula Martins; Rocha, Maria Eduarda Quidute Arrais; Gomes, Camila Rabelo Ferreira; Rodrigues Sobrinho, Carlos Roberto Martins.
Título: Syncope in patients with cardiac pacemakers
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);36(1):18-24, Jan.-Feb. 2021. tab, graf.
Idioma: en.
Resumo: Abstract Introduction: It is challenging to diagnose syncope in patients with pacemakers. Because these patients have increased morbidity and mortality risks, they require immediate attention to determine the causes in order to provide appropriate treatment. This study aimed to investigate the causes and predictive factors of syncope as well as the methods used to diagnose syncope in cardiac pacemaker patients. Methods: Patients with pacemakers implanted owing to sinus node disease or atrioventricular block were evaluated with standardized questionnaires, endocavitary electrograms, and other tests based on the suspected causes of syncope. Mann-Whitney U tests were used to analyze continuous variables and Chi-squared or Fisher's exact tests were used for categorical variables. Logistic regression was used for multivariate analyses. Statistical significance was P<0.05. Results: The study included 95 patients with pacemakers: 47 experienced syncope in the last 12 months and 48 did not. Of the 100 documented episodes of syncope, 48.9% were vasovagal syncopes, 17% had cardiac-related causes, 10.6% had unknown causes, and 8.5% had pacemaker failure. The multivariate analysis showed that a New York Heart Association (NYHA) Functional Class II was a significant factor for developing syncope (P<0.01). Conclusion: While the most common type of syncope in pacemaker patients was neurally mediated, it is important to perform detailed evaluations in this population as the causes of syncope can be life-threatening. The best diagnostic methods were stored electrogram analysis and the tilt table test. NYHA Functional Class II patients were found to have a higher risk for syncope.
Descritores: Marca-Passo Artificial
Síncope Vasovagal/diagnóstico
Síncope Vasovagal/etiologia
Síncope Vasovagal/terapia
Bloqueio Atrioventricular
-Síncope/diagnóstico
Síncope/etiologia
Teste da Mesa Inclinada
Limites: Humanos
Responsável: BR1.1 - BIREME



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