Tuesday, March 28, 2017

Tilt-table test

  1. is used to indentify cause of SENCOPE
  2. we will identify cause of sencope: vasodepressor or cardioinhibitory
  3. patient lay on table in the supin position
  4. tilting the table maximum: 60-80degrees for 25-40minute
  5. What is result? - Nothing? Lets repeat test with drugs which provoke sencope.
  6. Which drugs we can use? - sublingual nitroglycerin, epinephrine, adenosine, mostly-isoproterenol
  7. Role of isoproterenol: - induces a vasodepressor (decrease in heart rate and blood pressure)
  8. Neurocardyogenic sencopes: Vasodepressor, Carboinhibitory, Mixed
  9. What results can be?: Autonomic failure, Postural Tachycardia, Vasodepresor,
    RESPONSES

    a normal response is an early, slight drop in BP with a compensatory increase in HR mediated by the autonomic nervous system.


    With autonomic dysfunction, a progressive fall in BP is not counteracted by an increase in HR

    In postural tachycardia syndrome, an exaggerated increase in HR is seen


    Vasodepressor is a type of neurocardiogenic sencope. Pure vasodepressor response is a relatively sudden drop in BP without a marked change in HR

    cardioinhibitory is also neurocadiogenic sencope. Cardioinhibitory response shows a sudden decrease in HR without a change in BP

    A mixed response shows decreases in both HR and BP.(also neurocardiogenic sencope)