Question of the Week # 410

410)  A 30 year old man presents to the emergency room after having had a syncopal episode. His girl friend reports he suddenly collapsed to the floor and lost consciousness for few minutes. There was no evidence of tonic clonic movements. After regaining his consciousness, he was completely alert and awake. He reports he has had sweating and nausea prior to the episode. He has had about 2 to 3 such episodes per year for past several years. He was admitted for similar episodes in the past and telemetry monitoring was uneventful. He denied any chest pain, shortness of breath or palpitations prior to the episode. He has no other significant medical problems. On examination, his vitals are stable. He is completely awake and oriented. There are no focal neurological deficits. Cardiac examination is normal with out any murmurs. Laboratory investigations revealed a normal hemoglobin, blood glucose and electrolytes. An electrocardiogram is within normal limits. Which of the following is indicated next?

A) Holter Monitoring

B) CT scan of the Head

C) Tilt-Table testing

D) Carotid Doppler

E) Electrophysiology Study

10 Responses

  1. a

  2. It’s neurocardiogenic syncope ,so do tilt table test

  3. normal recovery, no cp, no tachy the only thing is nausea and swatting that before the episode, normal gluco, C?

  4. C.Tilit table testing

  5. C) Tilt-Table testing – Neurocardiogenic syncope

  6. C) Tilt-Table testing

  7. C. Vasovagal

  8. C

  9. a

  10. tilt test!

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