Osman BETON, Remzi KARAOĞUZ, Muharrem GÜLDAL, Ömer AKYÜREK, Şahin MÜRSELOV, Cansın TULUNAY, Timuçin ALTIN

Sinüs düğüm fonksiyon bozukluğu ve egzersiz sonrası oluşan vasovagal senkop

Vasovagal senkop yapısal kalp hastalığı olmayan bireylerde en sık senkop nedenidir. Ağrı, duygusal stres, uzun süre ayakta kalma gibi nedenlerle ortaya çıkmakla birlikte nadiren egzersiz ile ilişkili olabilmektedir. Sinüs düğüm disfonksiyonu ile vasovagal senkopun sık olarak birlikte görüldüğü de bildirilmiştir. Bu yazıda egzersiz sonrası vasovagal senkop ile birlikte elektrofizyolojik çalışmada sinüs düğüm disfonksiyonu saptanan bir hasta sunulmuştur.

Sinus node dysfunction and postexentional vasovagal syncope

Vasovagal syncope is the most common cause ofsyncope in patients without structural heart disease. it is most commonly associated with pain, emotional stress, ör prolonged standing whereas rare cases after exercise have been reported. it has also been reported that vasovagal syncope is common in patients with sinüs node dysfunction. in this report, we present a patient who had postexertional vasovagal syncope with sinüs node dysfunction in electrophysiologic study.

PDF

___

1. Kapoor WN. Syncope. In: Rosendorff C, ed. Essen- tial Cardiology: Principles and Practice. Philedelp- hia, Pennsylvania: WB Saunders Co, 2001; Chapter 18:332-344
2. Benditt DG, Ferguson DW, Grubb BP et al. ACC Ex¬ pert Consensus Document.: Tilt table testing for as¬ sessing syncope. J Am Coll Cardiol 1996; 28:263- 275
3. Mathias CJ, Deguchi K, Schatz I. Observations on recurrent syncope and presyncope in 641 patients. Lancet 2001; 357:348-353
4. Diker E, Polat K, Aydoğdu S. Egzersizle oluşan nö- rokardiyojenik senkop olgusu. Türk Kardiyoloji der- neği Arşivi 2002; 31:317-320
5. Osswald S, Brooks R, O'Nunain SS et al. Asystole af- ter exercise in healthy persons. Ann Intern Med 1994; 120:1008-1011
6. Lowe MD, Petch MC. Syncope after effort. Postgrad Med J 2000; 76:164-165
7. Thomson HL, Atherton JJ, Khafagi FA, Frenneaux MP. Failure of reflex venoconstriction during exerci- se in patients with vasovagal syncope. Circulation 1996; 93:953-959
8. Yerg JE, Seals DR, Hagberg JM, Ehsani AA. Syncope secondary to ventricular asystole in an endurance athlete. Clin Cardiol 1986; 9: 220-222
9. Crisafulli A, Melis F, Orrıı V, Lener R, Lai C, Concu A. Hemodynamic during postexertional asystolia in a healthy athlete: a case study. Med Sci Sports Exerc 2000; 32:4-9
10. Brignole M, Menozzi C, Bottoni N et al. Mecha- nisms of syncope caused by transient bradycardia and the diagnostic value of electrophysiologic tes- ting and cardiovascular reflexity maneuvers. Am J Cardiol 1995; 76:273-278
11. Brignole M, Menozzi C, Gianfranchi L, Oddone D, Lolli G, Bertulla A. Neurally mediated syncope de¬tected by carotid sinus massage and head-up tilt test in sick sinus syndrome. Am J Cardiol 1991; 68:1032-1036
12.Sgarbossa EB, Pinski SL, JaegerFJ, Trohman RG, Ma-loney JD. Incidence and predictors of syncope in paced patients with sick sinus syndrome. Pacing Clin Electrophysiol 1992; 15:2055-2060
13. Calkins H, Zipes DP. Hypotension and syncope. In: Braunwald E, Zipes DP, Libby P eds. Heart Disease- A Textbook of Cardiovascular Medicine, Philedelp- hia, Pennsylvania: W.B. Saunders Company 2001; Chapter 27:932-940
14. Grubb BP. Pathophysiology and differential diagno- 1999; 84:30-90
15. Olgin JE, Zipes DP. Specific Arrhythmias: Diagnosis and Treatment. In: Braunwald E, Zipes DP, Libby P eds. Heart Disease-A Textbook of Cardiovascular Medicine, Philedelphia, Pennsylvania: W.B. Saun- ders Company 2001; Chapter 25:815-889
16. Doherty JU, Pern brook-Rogers D, Grogan W et al. Electrophysiologic evaluation and follow-up cha- racteristics of patients with recurrent unexplained syncope and presyncope. Am J Cardiol 1985; 55:703-708
17.Sra JS, Jazayeri MR, Avitall B et al. Comparison of cardiac pacing with drug therapy in the treatment of neurocardiogenic (vasovagal) syncope with bradycardia or asystole. N Engl J Med 1993; 328:1085-1090.