Key result
Clinical history is the most important diagnostic tool for assessing autonomic dysfunction of the heart, guiding the appropriate use of further investigations like tilt-testing and loop recorders.
A detailed clinical history remains the most important diagnostic tool for assessing autonomic dysfunction of the heart, guiding the appropriate use of further investigations like tilt-testing and loop recorders.
Detailed history taking should guide syncope evaluation to limit testing; leaves open the incremental utility of autonomic investigations when history is inconclusive.
The most important diagnostic tool available in assessment of dysfunction of the autonomic control of the heart is the clinical history which must be taken in the greatest possible detail including from the patient and witnesses of the syncope/event. Correct history taking will make many diagnoses avoiding need for further testing and guide further investigation if needed and when appropriate. This paper focusses on the investigation of patients when required, the available tests, their indications, how to perform them for maximum yield and how to interpret the results. Tilt-testing, carotid sinus massage, active stand, cardiovascular autonomic nervous system tests, ambulatory blood pressure and insertable ECG loop recorder are covered.
No takes yet. Share an insight, caveat, or question.
A 2020 study conducted a review in Dysfunction of autonomic control of the heart. Diagnostic tools (clinical history, tilt-testing, carotid sinus massage, etc.) was evaluated. Clinical history is the most important diagnostic tool for assessing autonomic dysfunction of the heart, guiding the appropriate use of further investigations like tilt-testing and loop recorders.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: