Abstract：
:The first step in the diagnostic evaluation of patients with suspected syncope begins with an "initial evaluation" consisting of careful history taking, physical examination including orthostatic blood pressure measurement and electrocardiogram. However, even in expert centers the diagnostic yield of this "initial evaluation" is only approximately 50%. In the remaining cases in which a satisfactory diagnosis is either unknown or uncertain after initial assessment, additional clinical testing is needed. This article reviews the role of some of the more commonly used additional diagnostic tests, including: tilt-table testing, the active standing test, carotid sinus massage, electrophysiological testing, and the adenosine triphosphate (ATP) test. The role of angiography, exercise testing and imaging is noted briefly. Other clinical laboratory investigations, such as ambulatory ECG monitoring, are examined in other papers in this issue. In brief, clinical laboratory tests, carefully interpreted, may be useful in the evaluation of the basis of suspected syncope. However, these tests should be selected carefully and performed based on the pre-test probability inferred from the initial examination, and the less invasive tests should be used first.
journal_name
Prog Cardiovasc Disjournal_title
Progress in cardiovascular diseasesauthors
Blanc JJdoi
10.1016/j.pcad.2012.11.002subject
Has Abstractpub_date
2013-01-01 00:00:00pages
418-24issue
4eissn
0033-0620issn
1873-1740pii
S0033-0620(12)00209-5journal_volume
55pub_type
杂志文章,评审abstract：:Infective endocarditis continues to be associated with significant morbidity and mortality despite recent advances in its management and remains a serious and challenging condition requiring a multidisciplinary approach. Surgery is essential in at least 50% of cases. Surgical outcomes have improved with the introducti...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2008.08.007
更新日期：2009-05-01 00:00:00
abstract：:Tachycardia is a strong predictor of both hypertension and excessive cardiovascular risk. This association is robust and prevails after multivariate adjustments for other cardiovascular risk factors. Despite the strong evidence, various guidelines do not list tachycardia as a risk factor because of unwarranted assumpt...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2009.06.002
更新日期：2009-07-01 00:00:00
abstract：:Renal injury distal to an atherosclerotic renovascular obstruction reflects multiple intrinsic factors producing parenchymal tissue injury. Atherosclerotic disease pathways superimposed on renal arterial obstruction may aggravate damage to the kidney and other target organs, and some of the factors activated by renal ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2009.09.002
更新日期：2009-11-01 00:00:00
abstract：:Tricuspid regurgitation (TR) remains a complex valve pathology affecting nearly two million people in the United States. Although it can present as a primary valve pathology, TR often presents as a late finding in patients with severe pulmonary disease or end-stage chronic heart failure. Surgical repair of isolated TR...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2019.11.016
更新日期：2019-01-01 00:00:00
abstract：:Since the early 1900s, coffee has been implicated as having adverse effects on human health. Recent attention has focused on coffee's relation to CHD, but because of conflicting results of epidemiologic studies on coffee and CHD mortality, attention has turned to the effects of coffee and caffeine on individual CHD ri...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/0033-0620(89)90028-5
更新日期：1989-11-01 00:00:00
abstract：:Valvular heart disease (VHD) carries documented risks for active individuals. At the same time, many individuals with intermediate degrees of valve disease can safely exercise and even participate in competitive athletics. Unfortunately for clinicians caring for these patients, data are scarce. Understanding the patho...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2011.02.010
更新日期：2011-05-01 00:00:00
abstract：:With the approval of alteplase (tPA) therapy for stroke, it is likely that combination therapy with tPA to restore blood flow, and agents like glutamate receptor antagonists to halt or reverse the cascade of neuronal damage, will dominate the future of stroke care. The authors describe events and potential targets of ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(99)70002-2
更新日期：1999-11-01 00:00:00
abstract：:The response to injury in the vasculature and the heart is inflammation. Atherosclerosis is often the result of injury followed by inflammation and atherosclerosis. Vascular and myocardial infections from various pathogens, including viruses, bacteria, chlamydia, and other infections result in vascular inflammation an...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2002.123782
更新日期：2002-05-01 00:00:00
abstract：:The definition of syncope has clinical and pathophysiological parts. The clinical part is that syncope is a form of transient loss of consciousness (TLOC), while the pathophysiological element is that syncope differs from other forms of TLOC by virtue of the basis of true syncope - specifically cerebral hypoperfusion....
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2012.10.016
更新日期：2013-01-01 00:00:00
abstract：:Acute myocardial infarction is caused by coronary occlusion, and the mainstay of treatment has become reperfusion by either coronary angioplasty with possible stenting or surgical bypass grafting. Unfortunately, reperfusion can seldom be done soon enough to prevent infarction. Thus, the search for effective cardioprot...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2006.02.005
更新日期：2006-03-01 00:00:00
abstract：:In contrast to heart transplantation, little effort has been made to estimate the economic implications of mechanical cardiac assistance from either a procedure- or a program-level perspective. With annual direct and indirect expenditures for the treatment of coronary artery disease and congestive heart failure now ex...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2000.7201
更新日期：2000-07-01 00:00:00
abstract：:Rigorous training remodels the heart of elite endurance athletes to produce the phenotype of the "athlete's heart." This remodeling, which advantages cardiac performance, creates challenges in the diagnosis of cardiac disorders within this population. This is particularly so for right ventricular pathologies because o...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2012.01.005
更新日期：2012-03-01 00:00:00
abstract：:There is concern in published reports and reviews that patients are being harmed or denied effective treatment by the use of questionable results from secondary analyses of data from clinical trials. A well-reported secondary analysis must make clear to the reader the uncertainty of the result--so clear, in fact, that...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2011.09.006
更新日期：2012-01-01 00:00:00
abstract：:People are at risk from noncommunicable diseases (NCD) and poor health habits, with interventions like medications and surgery carrying further risk of adverse effects. This paper addresses ways people are increasingly moving to healthy living medicine (HLM) to mitigate such health threats. HLM-seekers increasingly le...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2016.12.006
更新日期：2017-01-01 00:00:00
abstract：:The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2018.11.005
更新日期：2018-01-01 00:00:00
abstract：:There are a number of difficulties inherent in the analysis of such a large and diverse quantity of data. In a substantial number of clinical trials, there is no significant effort made to evaluate prosthetic performance as a function of preoperative cardiac anatomy. Hemodynamics have not been systematically studied i...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/0033-0620(83)90008-7
更新日期：1983-11-01 00:00:00
abstract：:Left ventricular (LV) ejection fraction (EF) and LV end-systolic volumes are important measures of LV global function. However, in many patients with symptoms of heart failure, these measures are within normal limits. This condition is classified as heart failure with normal ejection fraction (HFNEF). Reduced EF and i...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2006.08.008
更新日期：2006-11-01 00:00:00
abstract：:Left ventricular (LV) dysfunction has been shown to be significantly related to ongoing myocardial ischemia, hibernation, and thus, coronary artery disease. Current treatments for patients with LV dysfunction and concomitant coronary artery disease center around the potential benefit of coronary revascularization, in ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.01.003
更新日期：2013-03-01 00:00:00
abstract：:The repetitive respiratory events that characterize obstructive sleep apnea (OSA) are each followed by abrupt increases in heart rate and in pulmonary and systemic artery pressure and by sudden decreases in right and left ventricular stroke volume. The changes in systemic pressure may be profound, with patients who ar...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.1999.0410367
更新日期：1999-03-01 00:00:00
abstract：:Physical inactivity is one of the major contributing factors to the global pandemic of non-communicable diseases. Unfortunately, low levels of habitual movement and physical activity (PA) are seen in an increasing proportion of populations across low- and middle-income countries and high-income countries alike. This n...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2020.10.006
更新日期：2020-10-30 00:00:00
abstract：:Cardiac imaging plays an important role in coronary artery disease (CAD), congestive heart failure (HF) and valvular heart disease (VHD) in the elderly. Imaging defines the structure and function of the cardiac system, refining the understanding of patients' anatomy and physiology and informing a host of clinical care...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2014.07.003
更新日期：2014-09-01 00:00:00
abstract：:Obesity, particularly severe obesity is capable of producing hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function. These include increased cardiac output, left ventricular hypertrophy and diastolic and systolic dysfunction of both ventricles. Facilitated by co-morbidities s...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.09.003
更新日期：2014-01-01 00:00:00
abstract：:Sugars are foundational to biological life and played essential roles in human evolution and dietary patterns for most of recorded history. The simple sugar glucose is so central to human health that it is one of the World Health Organization's Essential Medicines. Given these facts, it defies both logic and a large b...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2018.04.007
更新日期：2018-01-01 00:00:00
abstract：:Valvular heart disease is a common cause of increased mean pulmonary artery pressure (PAP). Aortic stenosis and mitral regurgitation are frequently accompanied by pulmonary hypertension (PH), especially when they are severe and symptomatic. In asymptomatic patients, PH is rare, though the exact prevalence is unknown a...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2016.06.004
更新日期：2016-07-01 00:00:00
abstract：:Cardiovascular magnetic resonance (CMR) imaging is a recognized technique for characterization of myocardial tissue in stable ischemic heart disease. In addition, CMR is emerging as a noninvasive imaging tool that can provide supporting information to guide treatment in acute coronary syndromes (ACSs). The advantages ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2011.09.001
更新日期：2011-11-01 00:00:00
abstract：:The revolution in cardiac care over the past two decades, characterized by emergent revascularization, drug eluting stents, anti-platelet medications, and advanced imaging has had little impact on overall ACS recurrence, or ACS prevention. The "Perfect Storm" refers to a confluence of events and processes, including a...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.03.003
更新日期：2013-05-01 00:00:00
abstract：:The Ephedra alkaloids have received much press lately secondary to reported adverse events in those using whole extracts as "dietary supplements" for weight loss or athletic performance enhancement. These reports are troubling given the increasing use of these supplements by the general public. We reviewed the availab...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2004.07.006
更新日期：2005-01-01 00:00:00
abstract：OBJECTIVE:To perform a pilot evaluation of a pharmacist-led, multidisciplinary transitional care clinic for heart failure (HF) patients. BACKGROUND:Transitions of care in HF should include: medication reconciliation, multidisciplinary care, early post-discharge follow-up, and prompt intervention on HF signs and sympto...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章
doi：10.1016/j.pcad.2017.08.005
更新日期：2017-01-01 00:00:00
abstract：:It is being increasingly appreciated that a substantial number of patients with congestive heart failure (CHF) have relatively preserved systolic function. Although these individuals appear to have a somewhat better prognosis than those with low ejection fractions, they experience significant symptoms and frequently r...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(98)80053-4
更新日期：1998-01-01 00:00:00
abstract：:Historically, risk stratification for survivors of acute myocardial infarction (AMI) has centered on 3 principles: assessment of left ventricular function, detection of residual myocardial ischemia, and estimation of the risk for sudden cardiac death. Although these factors still have important prognostic implications...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2000.0420273
更新日期：2000-01-01 00:00:00
