SENKOPLU HASTAYA YAKLAŞIM ve TEDAVİSİ; KARDİYOLOG GÖZÜYLE BAKIŞ

Yıl 2014, Cilt: 21 Sayı: 3, 102 - 109, 30.09.2014

Mehmet Koray Adalı , Ercan Varol

Öz

Özet
Senkop hızlı başlangıç, kısa süre ve spontan tam iyileşme ile karakterize, geçici global serebral hipoperfüzyona bağlı bir geçici bilinç kaybıdır. Hastalık değil, semptomdur. Presenkop deyimi, senkopta bilinçsizlikten önce görülen semptomlar ve belirtiler için kullanılır. Sistolik kan basıncının 70 mmHg, ortalama arteryel basıncın 40 mmHg'nın altına düşmesi senkop ile sonuçlanır. Hastaneye başvuru nedenlerinin %6'sını, acil servise başvuru nedenlerinin %3'ünü oluşturur. Kardiyak kökenli senkopta mortalite %18-33 olup nonkardiyak nedenlere göre daha ölümcül seyreder. Bu derlemede senkop kardiyovasküler açıdan özetlenmiştir.
Anahtar kelimeler: Senkop, etyoloji, tedavi
Abstract
Syncope is a temporary loss of conciousness related to temporary global hypoperfusion which is characterized with short duration and complete remission. It is a symptom not a disease. Presyncope term is used for sings and symptoms which are seen just before syncope. Lower than 70 mmHg systolic and 40 mmHg diastolic blood pressure results in syncope. Syncope is seen 6% of clinical and 3% of emergency applications. Mortality in cardiac syncope is 18-33% and it is more fatal than non-cardiac causes. In this review sencop was reviewed from the cardiovascular aspect.
Key words: Syncope, etiology, treatment

Anahtar Kelimeler

Senkop, etyoloji, tedavi

Kaynakça

• Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, Deharo JC, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Ruiz Granell R, Sarasin F, Ungar A, van Dijk JG, Walma EP, Wieling W. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J. 2009 Nov;30(21):2631-71.
• Griffin BP, Topol EJ. Kardiyovasküler Hastalıklar El kitabı. Çeviri Editörü: Doç. Dr. Enver Atalar. 2010; 33 (7):487-99.
• Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ et al. Incidence and prognosis of syncope. N Engl J Med. 2002 Sep 19;347(12):878- 85.
• Suzuki M, Hori S, Aikawa N. Application of the recent American practice resources for risk stratification system for patients presenting to a Japanese emergency department because of syncope. Int Heart J. 2007 Jul;48(4):513-22.
• Martin TP, Hanusa BH, Kapoor WN. Risk stratification of patients with syncope. Ann Emerg Med. 1997 Apr;29(4):459-66.
• Quinn J, McDermott D, Stiell I, Kohn M, Wells G. Prospective validation of the San Francisco Syncope Rule to predict patients with serious outcomes. Ann Emerg Med. 2006 May;47(5):448-54. Epub 2006 Jan 18.
• Middlekauff HR, Stevenson WG, Stevenson LW, Saxon LA. Syncope in advanced heart failure: high risk of sudden death regardless of origin of syncope. J Am Coll Cardiol. 1993 Jan;21(1):110-6.
• van Dijk JG, Sheldon R. Is there any point to vasovagal syncope? Clin Auton Res 2008;18:167–169.
• Kerr SR, Pearce MS, Brayne C, Davis RJ, Kenny RA. Carotid sinus hypersensitivity
• in asymptomatic older persons: implications for diagnosis of syncope and falls. Arch Intern Med 2006;166:515–520.
• Krahn A, Klein G, Norris C, Yee R. The etiology of syncope in patients with negative tilt table and 1995;92:1819–1824. testing. Circulation
• Benditt DG, Ferguson DW, Grubb BP, Kapoor WN, Kugler J, Lerman BB, Maloney JD, Raviele A, Ross B, Sutton R, Wolk MJ, Wood DL. Tilt table testing for assessing syncope. American College of Cardiology. J Am Coll Cardiol 1996;28:263–275.
• Morillo CA, Klein GJ, Zandri S, Yee R. Diagnostic accuracy of a low-dose isoproterenol
• head-up tilt protocol. Am Heart J 1995;129:901–906.
• Pezawas T, Stix G, Kastner J, Wolzt M, Mayer C, Moertl D, Schmidinger H. Unexplained syncope in patients with structural heart disease and no documented ventricular arrhythmias: value of electrophysiologically guided implantable cardioverter 2003;5:305–312. therapy. Europace
• Deharo JC, Jego C, Lanteaume A, Djiane P. An implantable loop recorder study of highly symptomatic vasovagal patients: the heart rhythm observed during a spontaneous syncope is identical to the recurrent syncope but not correlated with the head-up tilt test or adenosine triphosphate test. J Am Coll Cardiol 2006; 47:587–593.
• Steinberg JS, Prystowsky E, Freedman RA, Moreno F, Katz R, Kron J et al. Use of the signal-averaged electrocardiogram for predicting inducible ventricular tachycardia in patients with unexplained syncope: relation to clinical variables in a multivariate analysis. J Am Coll Cardiol. 1994 Jan;23(1):99-106.
• Krediet CT, van Dijk N, Linzer M, van Lieshout JJ, Wieling W. Management of vasovagal syncope: controlling or aborting faints by leg crossing and muscle tensing. Circulation 2002;106:1684–1689.
• Rosanio S, Schwarz ER, Ware DL, Vitarelli A. Syncope in adults: Systematic review and proposal of a diagnostic and therapeutic algorithm. Int J Cardiol. 2011 Dec 20.
• Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H, Gasparini M, Linde C, Morgado FB, Oto A, Sutton R, Trusz-Gluza M; European Society of Cardiology; European Heart Rhythm Association. Guidelines for cardiac pacing and cardiac resynchronization therapy. Eur Heart J 2007;28:2256–2295.