Author + information
- M. Rafanelli,
- G. Filice,
- I. Olivotto,
- N. Marchionni and
- A. Ungar
Prognostic stratification and clinical management of patients with hypertrophic cardiomyopathy and syncope are complex. This is a pilot Syncope Unit experience on standardized management of syncope in hypertrophic cardiomyopathy.
Patients with hypertrophic cardiomyopathy referred for syncope from the Referral Centre for Cardiomyopathies to the Syncope Unit, Careggi University Hospital, Florence between May 2004 and May 2016, were retrospectively analyzed. Three presyncope and 3 unexplained falls, were included.
20 consecutive patients. Mean age 55 ± 19 years. The 70% had syncope, 65% presyncope, 15% unexplained falls. Initial diagnosis: 25% orthostatic hypotension, 20% neurally-mediated syncope, 10% cardiac syncope, 35% unexplained. Tilt Test was diagnostic in 58%, 71% vasodepressive. Orthostatic hypotension was confirmed in 50%. A loop recorder was implanted in 5 patients, diagnostic in 60%. Final diagnosis: 50% neurally-mediated syncope-orthostatic hypotension, 20% arrhythmic, 10% unexplained. Tailored treatment was made.
A standardized management of syncope in hypertrophic cardiomyopathy reduces unexplained episodes, allowing a proper treatment.