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Situational syncope

MedGen UID:
87408
•Concept ID:
C0340854
•
Disease or Syndrome
Synonyms: Situational Syncope; Situational Syncopes; Syncope, Situational; Syncopes, Situational
SNOMED CT: Situational syncope (234167006)

Definition

A condition in which neurally-mediated syncope occurs due to a specific circumstance, such as micturition, defecation, coughing, or traction of the hair. (ACC-AHA) [from NCI]

Professional guidelines

PubMed

Syncope: Approaches to Diagnosis and Management.
Palaniswamy C, Aronow WS, Agrawal N, Balasubramaniyam N, Lakshmanadoss U
Am J Ther 2016 Jan-Feb;23(1):e208-17. doi: 10.1097/MJT.0b013e318256ed0f. PMID: 22960849
An approach to the clinical assessment and management of syncope in adults.
Ntusi NA, Coccia CB, Cupido BJ, Chin A
S Afr Med J 2015 Aug;105(8):690-3. doi: 10.7196/samjnew.8065. PMID: 26543940
Synopsis of the National Institute for Health and Clinical Excellence Guideline for management of transient loss of consciousness.
Cooper PN, Westby M, Pitcher DW, Bullock I
Ann Intern Med 2011 Oct 18;155(8):543-9. Epub 2011 Sep 19 doi: 10.7326/0003-4819-155-8-201110180-00368. PMID: 21930835

Recent clinical studies

Etiology

The clinical characteristics of situational syncope in children and adults undergoing head-up tilt testing.
Zou R, Wang S, Lin P, Hu C, Wang Y, Li F, Xu Y, Wang C
Am J Emerg Med 2020 Jul;38(7):1419-1423. Epub 2019 Nov 29 doi: 10.1016/j.ajem.2019.11.042. PMID: 31843331
Does A Therapy for Reflex Vasovagal Syncope Really Exist?
Romano S, Branz L, Fondrieschi L, Minuz P
High Blood Press Cardiovasc Prev 2019 Aug;26(4):273-281. Epub 2019 Jul 11 doi: 10.1007/s40292-019-00327-3. PMID: 31297720
Syncope: Approaches to Diagnosis and Management.
Palaniswamy C, Aronow WS, Agrawal N, Balasubramaniyam N, Lakshmanadoss U
Am J Ther 2016 Jan-Feb;23(1):e208-17. doi: 10.1097/MJT.0b013e318256ed0f. PMID: 22960849
Drugs and pacemakers for vasovagal, carotid sinus and situational syncope.
Romme JJ, Reitsma JB, Black CN, Colman N, Scholten RJ, Wieling W, Van Dijk N
Cochrane Database Syst Rev 2011 Oct 5;(10):CD004194. doi: 10.1002/14651858.CD004194.pub3. PMID: 21975744
Neurally-mediated syncope.
Brignole M
Ital Heart J 2005 Mar;6(3):249-55. PMID: 15875516

Diagnosis

Comorbidity of Neurally Mediated Syncope and Allergic Disease in Children.
Wang Y, Du J, Jin H, Liao Y
Front Immunol 2020;11:1865. Epub 2020 Aug 28 doi: 10.3389/fimmu.2020.01865. PMID: 32983103Free PMC Article
Does A Therapy for Reflex Vasovagal Syncope Really Exist?
Romano S, Branz L, Fondrieschi L, Minuz P
High Blood Press Cardiovasc Prev 2019 Aug;26(4):273-281. Epub 2019 Jul 11 doi: 10.1007/s40292-019-00327-3. PMID: 31297720
Pathophysiology of reflex syncope: A review.
Adkisson WO, Benditt DG
J Cardiovasc Electrophysiol 2017 Sep;28(9):1088-1097. doi: 10.1111/jce.13266. PMID: 28776824
Syncope: Approaches to Diagnosis and Management.
Palaniswamy C, Aronow WS, Agrawal N, Balasubramaniyam N, Lakshmanadoss U
Am J Ther 2016 Jan-Feb;23(1):e208-17. doi: 10.1097/MJT.0b013e318256ed0f. PMID: 22960849
Neurally-mediated syncope.
Brignole M
Ital Heart J 2005 Mar;6(3):249-55. PMID: 15875516

Therapy

Cardioinhibitory syncope with asystole during nitroglycerin potentiated head up tilt test: prevalence and clinical predictors.
Russo V, Parente E, Rago A, Comune A, Laezza N, Papa AA, Chamberland C, Huynh T, Golino P, Brignole M, Nigro G
Clin Auton Res 2022 Jun;32(3):167-173. Epub 2022 May 6 doi: 10.1007/s10286-022-00864-3. PMID: 35524080Free PMC Article
Isoproterenol Causing Coronary Vasospasm and ST Elevations During Tilt Table Testing.
Duong H, Masarweh OM, Campbell G, Win TT, Joolhar F
J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620966862. doi: 10.1177/2324709620966862. PMID: 33078637Free PMC Article
Citrus fruits induced swallow syncope with atrioventricular block or sinus arrest.
Yamaguchi Y, Mizumaki K, Sakamoto T, Nakatani Y, Tsujino Y, Inoue H, Kinugawa K
J Electrocardiol 2018 Jul-Aug;51(4):613-616. Epub 2018 Apr 18 doi: 10.1016/j.jelectrocard.2018.04.012. PMID: 29996999
Drugs and pacemakers for vasovagal, carotid sinus and situational syncope.
Romme JJ, Reitsma JB, Black CN, Colman N, Scholten RJ, Wieling W, Van Dijk N
Cochrane Database Syst Rev 2011 Oct 5;(10):CD004194. doi: 10.1002/14651858.CD004194.pub3. PMID: 21975744
Deglutition syncope: a manifestation of vagal hyperactivity following carotid endarterectomy.
Endean ED, Cavatassi W, Hansler J, Sorial E
J Vasc Surg 2010 Sep;52(3):720-2. Epub 2010 Jun 23 doi: 10.1016/j.jvs.2010.04.012. PMID: 20576395

Prognosis

Cardioinhibitory syncope with asystole during nitroglycerin potentiated head up tilt test: prevalence and clinical predictors.
Russo V, Parente E, Rago A, Comune A, Laezza N, Papa AA, Chamberland C, Huynh T, Golino P, Brignole M, Nigro G
Clin Auton Res 2022 Jun;32(3):167-173. Epub 2022 May 6 doi: 10.1007/s10286-022-00864-3. PMID: 35524080Free PMC Article
Clinical Characteristics and Outcome of Patients with Situational Syncope Compared to Patients with Vasovagal Syncope.
Wenzke KE, Walsh KE, Kalscheur M, Wasmund SL, Page RL, Brignole M, Hamdan MH
Pacing Clin Electrophysiol 2017 May;40(5):591-595. Epub 2017 Mar 23 doi: 10.1111/pace.13069. PMID: 28244210
Syncope: Approaches to Diagnosis and Management.
Palaniswamy C, Aronow WS, Agrawal N, Balasubramaniyam N, Lakshmanadoss U
Am J Ther 2016 Jan-Feb;23(1):e208-17. doi: 10.1097/MJT.0b013e318256ed0f. PMID: 22960849
An approach to the clinical assessment and management of syncope in adults.
Ntusi NA, Coccia CB, Cupido BJ, Chin A
S Afr Med J 2015 Aug;105(8):690-3. doi: 10.7196/samjnew.8065. PMID: 26543940
Situational syncope: response to head-up tilt testing and follow-up: comparison with vasovagal syncope.
Livanis EG, Leftheriotis D, Theodorakis GN, Flevari P, Zarvalis E, Kolokathis F, Kremastinos DT
Pacing Clin Electrophysiol 2004 Jul;27(7):918-23. doi: 10.1111/j.1540-8159.2004.00559.x. PMID: 15271010

Clinical prediction guides

Syncope without prodromes is associated with excessive plasma release of adenosine at the time of syncope during head-up tilt table test.
Fragakis N, Antoniadis AP, Sotiriadou M, Virgiliou C, Ballauri I, Gika HG, Bougiouklis D, Gerou S, Lazaridis C, Vergopoulos S, Bakogiannis C, Giannopoulos G, Theodoridis GA, Papadopoulos CE, Karamitsos TD, Vassilikos V
Int J Cardiol 2022 Sep 15;363:43-48. Epub 2022 Jun 16 doi: 10.1016/j.ijcard.2022.06.045. PMID: 35716941
Cardioinhibitory syncope with asystole during nitroglycerin potentiated head up tilt test: prevalence and clinical predictors.
Russo V, Parente E, Rago A, Comune A, Laezza N, Papa AA, Chamberland C, Huynh T, Golino P, Brignole M, Nigro G
Clin Auton Res 2022 Jun;32(3):167-173. Epub 2022 May 6 doi: 10.1007/s10286-022-00864-3. PMID: 35524080Free PMC Article
Diagnostic role of head-up tilt test in patients with cough syncope.
Mereu R, Taraborrelli P, Sau A, Di Toro A, Halim S, Hayat S, Bernardi L, Francis DP, Sutton R, Lim PB
Europace 2016 Aug;18(8):1273-9. Epub 2016 Jan 18 doi: 10.1093/europace/euv283. PMID: 26787669Free PMC Article
Syncope: Approaches to Diagnosis and Management.
Palaniswamy C, Aronow WS, Agrawal N, Balasubramaniyam N, Lakshmanadoss U
Am J Ther 2016 Jan-Feb;23(1):e208-17. doi: 10.1097/MJT.0b013e318256ed0f. PMID: 22960849
Clinical characteristics of defecation and micturition syncope compared with common vasovagal syncope.
Bae MH, Kang JK, Kim NY, Choi WS, Kim KH, Park SH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC, Jun JE
Pacing Clin Electrophysiol 2012 Mar;35(3):341-7. Epub 2011 Dec 21 doi: 10.1111/j.1540-8159.2011.03290.x. PMID: 22188510

Recent systematic reviews

Drugs and pacemakers for vasovagal, carotid sinus and situational syncope.
Romme JJ, Reitsma JB, Black CN, Colman N, Scholten RJ, Wieling W, Van Dijk N
Cochrane Database Syst Rev 2011 Oct 5;(10):CD004194. doi: 10.1002/14651858.CD004194.pub3. PMID: 21975744

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