Recognizing Life-Threatening Causes of Syncope

Khoo, Clarence; Chakrabarti, Santabhanu; Arbour, Laura; Krahn, Andrew D.

doi:10.1016/j.ccl.2012.10.005

Cited by 11 publications

(11 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is characterized by the left ventricular wall thickness ≥15 mm with non-dilated ventricular chambers and microscopic myofibrillar disarray (Gersh et al, 2011). Left ventricular outflow tract obstruction can occur in patients who have septal hypertrophy, leading to mechanical obstruction to flow during exercise, or ventricular arrhythmias that lead to syncope or sudden cardiac death (Khoo et al, 2013). Syncope is a major risk factor for sudden death in HCM, and should lead to consideration of implantation of an implantable cardioverter defibrillator (ICD).…”

Section: Familial Cardiomyopathiesmentioning

confidence: 99%

“…Less common causes of cardiomyopathy include infiltrative processes such as amyloidosis or hemochromatosis, and inherited causes such as hypertrophic cardiomyopathy (HCM) or arrhythmogenic right ventricular cardiomyopathy (ARVC), familial dilated cardiomyopathy and myotonic dystrophy (Khoo et al, 2013). In most cases, the risk of sudden cardiac death (SCD) due to ventricular arrhythmia is proportional awareness of the need to exclude underlying cardiomyopathy in evaluating the patient with syncope is crucial to understanding prognosis and preventing sudden death.…”

Section: Cardiomyopathymentioning

confidence: 99%

“…Syncope associated with structural cardiac disease or a channelopathy is associated with an increased risk of death (Ungar et al, 2010) and its treatment is often effective in reducing mortality (Khoo et al, 2013). Although this accounts for a minority of all syncope presentations, a comprehensive understanding of these conditions is essential.…”

Section: Etiologymentioning

confidence: 99%

See 2 more Smart Citations

Life threatening causes of syncope: Channelopathies and cardiomyopathies

Herman

Bennett

Chakrabarti

et al. 2014

Autonomic Neuroscience

Self Cite

View full text Add to dashboard Cite

Section: Familial Cardiomyopathiesmentioning

confidence: 99%

Section: Cardiomyopathymentioning

confidence: 99%

Section: Etiologymentioning

confidence: 99%

See 1 more Smart Citation

Life threatening causes of syncope: Channelopathies and cardiomyopathies

Herman

Bennett

Chakrabarti

et al. 2014

Autonomic Neuroscience

Self Cite

View full text Add to dashboard Cite

“…The identification of high-risk syncopal individuals requires a careful history, examination and a 12-lead ECG. These will guide subsequent evaluation for the need of further non-invasive or invasive testing modalities to confirm the diagnosis 1. An echocardiogram is a helpful screening test in confirming or refuting the presence of structural heart disease as well as risk stratifying individuals based on the left ventricular ejection fraction 1 18 19…”

Section: Discussionmentioning

confidence: 99%

Sinus pauses and high-grade atrioventricular block in Albright's hereditary osteodystrophy with pseudopseudohypoparathyroidism

Rahmat

Venables²

2013

BMJ Case Reports

View full text Add to dashboard Cite

Albright's hereditary osteodystrophy (AHO) is a rare inherited syndrome involving the molecular defects in the gene encoding the α subunit of the stimulatory G protein (Gsα). AHO has several variants, mainly pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP). We present a family that share the same inactivating GNAS1 mutation, the daughter being affected by PPHP and her late father with PHP. The daughter, in her late teens, presented with a long history of presyncopal and syncopal attacks. Her father died suddenly in his mid-40 s. As expected, her laboratory tests to date have shown normal biochemistry and hormonal levels. Subsequently, an implantable loop recorder was inserted. This demonstrated extreme sinus pauses of >11 s and also high-grade atrioventricular block. A dual-chamber pacemaker was therefore inserted.

show abstract

“…[27][28][29][30] Less frequently, syncope results from serious cardiovascular conditions that result in transient loss of cerebral blood flow because of an obstruction or arrhythmias associated with underlying structural heart disease. 31 Primary electrical disorders can result in syncope in the absence of any structural heart disease. 32 Syncope or presyncope in an athlete mandates a thorough evaluation by a qualified clinician.…”

Section: Syncopementioning

confidence: 99%

Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9: Arrhythmias and Conduction Defects

Zipes¹,

Link²,

Ackerman³

et al. 2015

Circulation

122

View full text Add to dashboard Cite

A broad range of variations in heart rates and rhythms, specific cardiac arrhythmias, and atrioventricular (AV) and intraventricular conduction disturbances are observed in athletes. Although most are common among nonathletes as well, the special circumstances and pressures related to athletic performance demand a high level of attention. The distinction between normal variants, often exaggerated by the specific physiology of the conditioned athlete, and arrhythmias that may be symptomatic or life-threatening may be significant challenges. Bradycardia Sinus BradycardiaSinus bradycardia, defined as a sinus rate <60 beats per minute (bpm), is common in the athlete.1 Generally, it is attributed to enhanced vagal tone caused by conditioning and is thus physiological. Occasionally, heart rates can be as slow as 30 to 40 bpm at rest in the highly conditioned athlete and decrease to <30 bpm during sleep. Some athletes with marked sinus bradycardia will exhibit periods of low atrial or junctional escape rhythms with rates of 40 to 60 bpm. This is a normal phenomenon, and these will become suppressed with exercise-induced increases in the sinus rate.Evaluation of the athlete with sinus bradycardia includes a careful history to determine whether the athlete has symptoms related to the bradycardia. In addition, physical examination and an ECG are warranted, with selective use of additional tests such as an echocardiogram and exercise stress test if underlying structural heart disease is suggested. Stress testing can also be used to verify a normal rate response to exercise, if judged to be necessary. The same approach applies to the sinus arrhythmia commonly observed in the athlete. Generally, asymptomatic sinus pauses or sinus arrest (<3 seconds) are not considered clinically significant unless accompanied by symptoms. Pauses of longer duration may fall within the spectrum of physiological responses to athletic conditioning; however, when accompanied by symptoms, sinus bradycardia, The American Heart Association and the American College of Cardiology make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.The Preamble and other Task Force reports for these proceedings are available online at http://circ.ahajournals.org (Circulation. 2015;132:e256-e261; e262-e266; e267-e272; e273-e280; e281-e291; e292-e297; e298-e302; e303-e309; e310-e314; e326-e329; e330-e333; e334-e338; e339-e342; e343-e345; and e346-e349).This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on June 24, 2015, and the American Heart Association Executive Committee on July 22, 2015, and by the American College of Cardiology Board of Trustees and Ex...

show abstract

Recognizing Life-Threatening Causes of Syncope

Cited by 11 publications

References 72 publications

Life threatening causes of syncope: Channelopathies and cardiomyopathies

Life threatening causes of syncope: Channelopathies and cardiomyopathies

Sinus pauses and high-grade atrioventricular block in Albright's hereditary osteodystrophy with pseudopseudohypoparathyroidism

Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9: Arrhythmias and Conduction Defects

Contact Info

Product

Resources

About