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TITLE:
Vasovagal syncope: asystole provoked by head-up
tilt testing under sertraline therapy.
AUTHOR:
Lenk MK; Alehan D; Ozme S; Celiker A; Ozer S
AUTHOR AFFILIATION:
Department of Pediatrics, Hacettepe University,
Faculty of Medicine, Ankara, Turkey.
SOURCE:
Turk J Pediatr 1997 Oct-Dec;39(4):573-7
NLM CIT. ID:
98094728
ABSTRACT:
Syncope is defined as a sudden transient loss of
consciousness. Vasovagally mediated hypotension and bradycardia are believed common, yet
difficult to diagnose, causes of syncope in healthy children and adolescents. These
episodes are often both sudden and sporadic in nature and, if recurrent and severe
(malignant vasovagal syncope), can be a source of morbidity and possibly mortality.
Head-up tilt testing has emerged as a useful investigation in patients who are thought to
have recurrent vasovagal syncope with systemic hypotension, bradycardia, or both, and it
has been suggested as a potential method to test for vasovagal episodes. Sertraline
hydrochloride, a serotonin reuptake inhibitor, has been reported to be effective in
preventing the vasovagal syncopal episodes in children and adults. Here, two cases of
recurrent, unexplained syncope are presented. Both were under sertraline therapy and
underwent provocative head-up tilt testing that resulted in asystole.
MAIN MESH SUBJECTS:
Heart Arrest/*ETIOLOGY/PHYSIOPATHOLOGY
Serotonin Uptake Inhibitors/*THERAPEUTIC USE
Syncope, Vasovagal/COMPLICATIONS/*DIAGNOSIS/*PREVENTION & CONTROL
*Tilt-Table Test
1-Naphthylamine/*ANALOGS & DERIVATIVES/THERAPEUTIC USE
When my office
lease expired at the end of 2004, I decided to turn it into a
"sabbatical" from my private practice. Many years ago, in my
grandfather's 89th year of life, he told me, "John, it is important
to smell the roses while you can still smell them." His life
gave living a very good reputation. It is also true that the
pursuit of that philosophy required my grandfather to to re-open his
assay office/ore market in Wickenburg, Arizona as a 75-year-old because
he had run a little short of retirement money. Thus, if blessed with his
luck and health, I'll be back.. --jjh
