Cardioinhibitory variant of syncope induced during a long-term passive orthostatic test

In patients suffering from recurrent syncope and after excluding other possible causes, it is recommended to conduct a longterm passive orthostatic test (tilt test) to document vasovagal disorders. The cardioinhibitory variant is confirmed if fainting occurs when there is a pause on the electrocardiogram. The article contains two clinical examples of the development of syncope with prolonged orthostasis. Patients reported a history of episodes of syncopal states. A long-term passive orthostatic test is a diagnostic method that allows differential diagnosis of syncopal conditions in patients. At the stage of diagnostic examination, both patients underwent computed tomography of the head, echocardiography, daily monitoring of ECG and blood pressure, electroencephalography. All indicators of laboratory and instrumental diagnostic methods in patients were within the normal range. In order to further verify the diagnosis, a long-term passive orthostatic test (tilt test) was prescribed in the department of functional diagnostics of the medical diagnostic center. In both cases, the samples were conducted according to the Westminster Protocol. As a result, syncopal conditions were induced with the development of neuroreflective syncope of the cardioinhibitory type with asystole (1 clinical case) and the development of a cardioinhibitory variant of syncope without asystole (2 clinical case), which were accompanied by convulsive syndrome. Thus, tilt test is used to create prolonged passive stress, which allows to identify the presence of autonomous factors that cause neuroreflective fainting in patients. The demonstrated clinical examples show variants of the development of a cardioinhibitory type of syncope during a tilt test. A positive result is determined by the appearance of clinical signs of presyncope or the development of syncope caused by a decrease in blood pressure and / or heart rate. This technique is indicated in patients with a high probability of a positive tilt test result.