Comorbid health conditions in women with syncope

Ulaş, Ümit Hıdır; Chelimsky, Thomas C.; Chelimsky, Gisela; Mandawat, Aditya; McNeeley, Kevin; Alshekhlee, Amer

doi:10.1007/s10286-010-0070-x

Cited by 16 publications

(18 citation statements)

References 31 publications

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“…Comorbidities were significantly more common in patients ≥65 years old. By comparison, in a large cohort of women, autonomic dysfunction was more common than in men, and most common in the 15‐ to 45‐year‐old range . Symptoms included migraine, chronic fatigue syndrome, gastroparesis, interstitial cystitis, orthostatic hypotension, postural orthostatic tachycardia syndrome, and autonomic neuropathy.…”

Section: Discussionmentioning

confidence: 94%

“…By comparison, in a large cohort of women, autonomic dysfunction was more common than in men, and most common in the 15-to 45-year-old range. 7 Symptoms included migraine, chronic fatigue syndrome, gastroparesis, interstitial cystitis, orthostatic hypotension, postural orthostatic tachycardia syndrome, and autonomic neuropathy. A Danish nationwide observational study of 127 508 patients hospitalized for a first-time syncope included patients with a median age of 65 years, 53% of whom were females and were older but with the same proportion of women as in our study population.…”

Section: Discussionmentioning

confidence: 99%

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Unexplained Syncope: Implications of Age and Gender on Patient Characteristics and Evaluation, the Diagnostic Yield of an Implantable Loop Recorder, and the Subsequent Treatment

Edvardsson

Garutti

Rieger

et al. 2014

Clinical Cardiology

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BackgroundSyncope is a common clinical problem with a variety of underlying mechanisms, some of which occur more frequently in 1 of the sexes or at a certain age.HypothesisThere may be clinically significant age- and gender-related differences in patients with unexplained syncope.MethodsFive hundred seventy patients (54% women) with unexplained syncope received an implantable loop recorder (ILR) and were followed until diagnosis or for at least 1 year.ResultsWomen were older and more prone to severe trauma during syncope (40.8% vs 29.9%, P = 0.007), and hospitalization was more common at ≥65 years (P = 0.003) without gender difference. Muscle spasms or grand mal seizures were more common in men and at <65 years old. Carotid sinus pressure, exercise testing, coronary angiography and magnetic resonance imaging/computed tomography scans were more commonly performed in men, whereas no test was more common in women. Tilt testing, exercise test, electroencephalography, and neurological or psychiatric evaluation were more common at ≥65 years. There were no age- or gender-related differences in the diagnostic yield of the ILR, whereas patients ≥65 years old more often received specific treatment based on ILR data.ConclusionsGender and/or age had relevance for the clinical evaluation, rate of recurrence, and subsequent specific treatment but not for the diagnostic yield of the ILR.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Unexplained Syncope: Implications of Age and Gender on Patient Characteristics and Evaluation, the Diagnostic Yield of an Implantable Loop Recorder, and the Subsequent Treatment

Edvardsson

Garutti

Rieger

et al. 2014

Clinical Cardiology

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show abstract

“…[5][6][7] Conversely, headache, including migraine, is the most common comorbidity in patients with autonomic disorders, such as postural tachycardia syndrome (POTS) and neurocardiogenic syncope, with the prevalence ranging between 27% and 96% in some case series. [8][9][10] One of the major underlying mechanisms in autonomic disorders, such as POTS, neurocardiogenic syncope, and orthostatic hypotension, is hypovolemia, which may be due, in part, to the disturbance of the renin-angiotensin-aldosterone system and resultant abnormalities in sodium and water retention. 11 The first-line therapeutic intervention for patients with autonomic disorders is plasma volume expansion via increased water and sodium consumption, which are effective nonpharmacologic measures for raising blood pressure, reducing orthostatic blood pressure drop, and ameliorating postural tachycardia.…”

Section: Comments Observations and Rebuttalsmentioning

confidence: 99%

Dietary Sodium Intake and Migraine: Is Salt the Answer?

Blitshteyn¹

2016

Headache

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“…The sophisticated signalling pathways required for normal bladder function are infinitely subject to perturbations of autonomic innervations . However, the defining factors linking distinct autonomic disorders and resultant lower urinary tract manifestations remains at the early stages of investigation . Indeed, initial studies have demonstrated a potential relationship between autonomic dysfunction and idiopathic OAB .…”

Section: Introductionmentioning

confidence: 99%

Overactive bladder and autonomic dysfunction: Lower urinary tract symptoms in females with postural tachycardia syndrome

Kaufman

Chang-Kit

Raj

et al. 2016

Neurourology and Urodynamics

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Aims Postural Tachycardia Syndrome (POTS) represents an autonomic disorder predominantly affecting females between 15 and 50 years of age. POTS is a chronic disorder (>6 months) characterized by an excessive heart rate increment on standing (>30 beats/min) in the presence of characteristic symptoms of cerebral hypoperfusion or sympathetic activation. Patients have clinically been noted to describe lower urinary tract symptoms (LUTS), although urologic symptoms have not been methodically assessed in the POTS population. Herein we present data from a pilot study designed to identify and quantitate overactive bladder (OAB) in patients diagnosed with POTS. Methods Patients admitted to the Vanderbilt Autonomic Dysfunction Center between June 2009 and October 2010 for evaluation for the potential diagnosis of POTS completed a validated, standardized questionnaire for OAB (OAB-q) at presentation. Symptom score and subscale analyses were conducted. Subscale health related quality of life (HRQL) scores were transformed into a 0–100 scale, with higher scores reflecting superior HRQL. Data are presented as mean ± SD. Results Thirty-two females presented for evaluation of symptoms consistent with POTS. Twenty-nine women were subsequently diagnosed with POTS with 19 of these patients completing the OAB-q questionnaire (65.5% response rate). Average age was 33.5 ± 8.3 years. Symptom severity transformed score was 26.0 ± 16.4, with 13 of 19 patients (68.4%) meeting clinical criteria for diagnosis of probable clinically significant OAB. Nocturia was the most bothersome symptom, followed by frequency and urgency. Conclusions This pilot study describes bothersome lower urinary tract dysfunction in patients presenting with POTS as assessed by patient-reported questionnaire data. Nocturia demonstrated the greatest negative impact on health-related quality of life (HRQL), while social interaction was the least affected HRQL domain. In patients with dysautonomia, this data provides a critical baseline for mechanistic insight into both disease-specific and global pathophysiology of nocturia and OAB.

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Comorbid health conditions in women with syncope

Abstract: A higher proportion of autonomic dysfunction was present in women compared to men. In addition, these comorbid autonomic conditions were especially prominent during the female reproductive age.

Cited by 16 publications

References 31 publications

Unexplained Syncope: Implications of Age and Gender on Patient Characteristics and Evaluation, the Diagnostic Yield of an Implantable Loop Recorder, and the Subsequent Treatment

Unexplained Syncope: Implications of Age and Gender on Patient Characteristics and Evaluation, the Diagnostic Yield of an Implantable Loop Recorder, and the Subsequent Treatment

Dietary Sodium Intake and Migraine: Is Salt the Answer?

Overactive bladder and autonomic dysfunction: Lower urinary tract symptoms in females with postural tachycardia syndrome

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