Patients who have fainting fit or ...

Patients who have fainting fit or presyncope while driving exhibit a diagnostic problem; electrophysiologic studies may identify a cause. Blitzer and associates retrospectively reviewed the records of 71 somebodys who had unexplained impaired consciousness while driving and were referr for electrophysiologic testing.

All patients had tilt-table testing, electrophysiologic studies, and evaluation of implantable cardiac defibrillators, if at hand Results of all other testing forward these patients also were garner uped Using commonly recognized test finis points, a presumptive diagnosis was made in 57 patients (80 percent) Vasovagal elision was diagnosed in 21 patients (30 percent) who had a suggestive history and a positive tilt-table exhibition Eighteen patients (25 percent) had an inducible supraventricular tachycardia forward electrophysiologic study. Twelve patients (17 percent) had ventricular tachycardia, either inducible upon electrophysiologic study or found in succession evaluation of their cardiac defibrillators.

Advanced atrioventricular blockade was noted in seven patients (10 percent) common patient (1 percent) was diagnosed with vestibular disease, and undivided patient was diagnosed with a seizure. Treatment based onward these diagnoses prevented any further episodes of impaired consciousness during the follow-up period (range, three month to 15 years). united patient had a recurrence after ablation of supraventricular tachycardia; tilt-table testing showed that the correct diagnosis was vasovagal elision This patient was treated favorably with beta blockers.

The authors terminate that vasovagal syncope is a customary cause of impaired consciousness while driving. Electrophysiologic testing can bring to light arrhythmias in these patients. A combination of tilt-table testing and electrophysiologic studies ensues in a high yield of diagnoses, allowing a greater likelihood of preventing further episodes by the agency of proper treatment.

Blitzer ML et al. Causes of impaired consciousness while driving a motorized vehicle. Am J Cardiol June 1 2003;91: 1373-4

COPYRIGHT 2004 American Academy of Family Physicians

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