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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-two chronic hemodialysis patients with hypertension were treated with prazosin. Eight patients had volume-responsive hypertension, 11 volume-indpendent, and 3 high-renin hypertension. Blood pressure fell in all volume-responsive patients from a predialysis level of 175 +/- 5/100 +/- 3 to 148 +/- 4/75 +/- 3 mm Hg (p less than 0.001) after 3 months of therapy. Prazosin alone was effective in volume responsive patients at a dose of 5 +/- 1.0 mg daily. The blood pressure fell in volume-indpendent patients from 192 +/- 7/105 +/- 2 mm Hg predialysis to 155 +/- 6/80 +/- 3 after 3 months (p less than 0.001). Two were controlled on prazosin alone at a dose of 12 +/- 2 mg daily. Nine required 27 +/- 5 mg of prazosin daily as well as additional antihypertensive treatment. The blood pressure fell from 183 +/- 3/109 +/- 6 mm Hg predialysis to 173 +/- 17/85 +/- 3 mm Hg in high-renin patients after 3 months. One patient was controlled on 40 mg of prazosin daily. Two required 40 mg of prazosin daily as well as additional antihypertensive medication. Eleven patients described transient dizziness within the first month of therapy. One patient had recurrent syncope necessitating prazosin withdrawal; Prazosin is an effective antihypertensive agent which can be used in all types of hypertensive dialysis patients either alone or in combination with minimal side effects.
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PMID:Effects of prazosin in the control of blood pressure in hypertensive dialysis patients. 9 39

Ninety symptomatic patients aged between 16 and 90 years were investigated by ambulatory continuous 24 hour electrocardiography. 75 of these patients underwent endocavitary exploration of atrioventricular conduction and sinus node function within 48 hour of ambulatory electrocardiography. Symptoms occurred during the recording in 30% patients, enabling the mechanism of the malaise to be determined. Every time that abnormalities in the zone surrounding the Tawara node were demonstrated by endocavitary recordings, the 24 hour electrocardiogramme showed the symptoms to be due to other causes than complete heart block. In 70% patients no symptoms were experienced but 58% of them had cardiac arrhythmias and particularly sinus node dysfunction (24 out of 37 patients) on the 24 hour electrocardiogramme. Comparing the results of these two methods of investigation, continuous electrocardiography appears to be a better technique for the diagnosis of sinus node dysfunction but endocavitary study of sinus node function would seem more suited to determine its severity. Endocavitary recordings seem more reliable in the investigation of paroxysmal atrioventricular blocks. These results demonstrate the complementary nature of these two methods in determining the causes of syncope and dizziness.
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PMID:[Comparison of 24 hours ambulatory electrocardiography and endocavitary recording in the diagnosis of heart rate disorders]. 10 88

ECG-tape recording has been utilized for diagnosis of transient attacks of syncope and dizziness both before and during cardiac pacing. The display unit can be utilized for automatic starting of the ECG writer according to markings made by the patient or bradycardia alarm. The method has proved extremely useful and convenient, which is illustrated by cases with different types of arrhythmia and pacemaker failure.
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PMID:ECG-tape recording for analysis of syncopal attacks before and during cardiac pacing. 28 Sep 40

The case reported concerns a symptomatic transitory sinus node abnormality in a 75 years old woman treated with Lithium Carbonate (750 mg/d) for a manic-depressive psychosis. This patient, admitted to the hospital for bradycardia and repeated episodes of syncope was shown to present sinus pauses greater than 3 seconds. Lithium therapy was discontinued. 72 hours later electrophysiologic studies, performed to evaluate sinus node function, were normal. It is therefore the author's opinion that in patients receiving Lithium therapy who present syncope, dizziness, or bradycardia a sinus node abnormality of iatrogenic origin must be considered. The importance of this diagnosis is in the rapid reversibility of the sinus node dysfunction with discontinuation of therapy.
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PMID:[Reversible sinus dysfunction during treatment with lithium carbonate]. 31 73

Holter monitoring was used to detect the underlying mechanism among 53 patients referred for dizziness, fainting and/or syncope. The complaints were unexplained on clinical grounds in 38, suggestive of SSS in 11, and of pacemaker dysfunction in 4 patients who underwent pacemaker implantation for symptomatic A-V block. Occult dysrhythmias were revealed in 24 of 38 (61%) of the first group; the clinical impression of SSS was confirmed in 8 of 11 (72%) in the second, and ineffective pacing confirmed in 2 of 4 in the third group. Thus, the diagnosis was clarified in 34 of 53 (64%) of patients. It is concluded that Holter monitoring is most useful for detecting the underlying mechanism in the above mentioned conditions, especially in elderly subjects whose syncopal attacks remained unexplained despite routine cardiological and neurological examination. Holter monitoring should be carried out for at least 36 hours before ruling out dysrhythmias as a cause of dizziness and/or syncopal attacks.
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PMID:Holter monitoring in dizziness and syncope. 31 6

Lithium salts have been widely used for several years in the treatment of manic-depressive psychosis. Various side-effects of lithium salts have been described. The present case report present two patients in whom sinus node dysfunction leading to syncope was caused by lithium. One of the cases showed signs of depressed sinus node function even when not on lithium, but no symptoms arose until lithium treatment was commenced. The second case showed no signs of depressed sinus node function when lithium was withdrawn. To study the prevalence of sinus node dysfunction in patients on lithium therapy, 97 consecutive patients on lithium were examined. The examination included case history, ECG and carotid massage. In two patients lithium could not be ruled out as being responsible for sinus node depression and in one patient the same was true for the atrioventricular node. None of these patients had any symptoms. It is concluded that lithium treatment may result in sinus node dysfunction. This side-effect is, however, not common. Lithium treatment can obviously be instituted in all patients without a history suggesting sinus node dysfunction. Patients with a history of dizziness and/or syncope should not be given lithium until thorough cardiological examination has been carried out. Likewise, a cardiological examination should be performed if patients on lithium develop symptoms of this type.
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PMID:Syncope caused by lithium treatment. Report on two cases and a prospective investigation of the prevalence of lithium-induced sinus node dysfunction. 37 17

Ten years ago a clinical method of recording the electrical activity of the His bundle in man with transvenously inserted electrodes was described. His bundle recording has permitted the breakdown of the P-R interval into three conduction intervals, i.e., intraatrial (P-A), A-V nodal (A-H), and His-Purkinje system (H-V). His bundle studies have demonstrated our inability to accurately predict from the surface electrocardiogram the exact location of most A-V blocks. First- and second-degree A-V block can occur in the atrium, A-V node or His-Purkinje system, and third-degree A-V block in the A-V node or His-Purkinje system. However, Mobitz type II block almost always occurs below the A-V node. Intraventricular conduction defects, especially of the so-called bifascicular block, have a high incidence of H-V time prolongation, indicating additional disease of the third fascicle or the main His bundle. The prognostic value of a prolonged H-V time in patients with and without chronic conduction defects remains controversial, with some agreement that patients with unexplained syncope or dizziness, normal sinus rhythm and 1:1 conduction, who show prolonged H-V times, should probably be paced permanently. No long-term studies exist regarding the value of the H-V time in predicting death or A-V block in patients with conduction defects secondary to acute myocardial infarction, congenital heart disease or after cardiac surgery. Electrophysiological studies have been extremely useful in the diagnosis and management of patients with accessory pathways and in the evaluation of ventricular and supraventricular arrhythmias. The most valuable test in diagnosing sinus node dysfunction is the sinus node recovery time. A clearly abnormal test in a patient with unexplained syncope or dizziness predicts an almost one hundred per cent relief of symptoms with permanent pacing.
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PMID:Diagnostic and prognostic value of intracardiac electrophysiological studies. Ten years of experience. 38 29

Computer-supported long-term ECG-analysis, must be considered as complementary to other methods of documentation concerning arrhythmias. With the introduction of computers in the last several years, exact quantification and qualification of arrhythmias, over long monitoring periods, has become possible. With this method diverse forms of documentation and data presentation enhance its value of information and increase plausibility. Major indications for long-term ECG-monitoring of ambulatory patients are detection of occult arrhythmias, evaluation of subjective symptoms such as dizziness or syncope, recognition of pacemaker dysfunctions, selection of patients with coronary heart disease at high risk and evaluation as well as control of the efficacy of antiarrhythmic therapy.
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PMID:[Documentation of arrhythmias - the value of long-term ECG monitoring]. 39 Sep 62

One hundred three patients with persistent sinus bradycardia were evaluated electrophysiologically and followed prospectively for a mean of 4.6 years. The 5-year survival rate was 74.8%, not significantly different from the 72% rate in the general population with similar age and sex distribution. Forty-one patients had abnormal corrected sinus-node recovery time. Overall accuracy of abnormal corrected sinus-node recovery time in predicting serious sinus node disease in symptomatic and asymptomatic patients was 90% (37 of 41 patients) and 100% in patients with syncope (18 of 18 patients). The sensitivity of the test was 66%. Abnormal corrected sinus-node recovery time in patients with sinus bradycardia appears to be a valuable specific, predictive index of serious sinus node disease and therefore a useful test in selecting patients for pacemaker therapy, especially if symptoms such as dizziness or syncope are present.
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PMID:Electrophysiologic evaluation of elderly patients with sinus bradycardia: a long-term follow-up study. 42 Apr 59

We prospectively evaluated 46 patients who had intrahisian conduction delay. Twenty-three had a split His potential and 23 had a prolonged HV interval with a normal QRS complex. In those with a split His, the interval between the two His potentials averaged 32.7 msec (range 9--90 msec); in nine patients this split His was demonstrated only by atrial pacing. The 20 patients from this group with 1:1 atrioventricular conduction have been followed for an average of 18.1 months (range 2--48 months). All are alive. Three have had syncope, but Holter monitoring revealed no bradyarrhythmias. In the 23 patients with a narrow QRS and prolonged HV interval, the HV interval averaged 73.7 msec (range 57--180 msec). Twelve of these patients received pacemakers at the time of the His bundle study, six had symptomatic atrioventricular block and five had symptomatic sinus pauses. The 11 patients who did not receive pacemakers have been followed for an average of 15.1 months (range 2--44 months). In three with recurrent syncope and five with dizziness, monitoring has revealed no bradyarrhythmias. One patient died from a myocardial infarction without arrhythmias. Further prospective evaluation of patients with intrahisian conduction delay without documented bradyarrhythmias is needed, but with follow-up averaging 17 months and up to 4 years, patients with intrahisian conduction delay and without documented bradyarrhythmias appear not to require prophylactic permanent pacemakers to decrease morbidity or mortality.
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PMID:Prospective evaluation of intrahisian conduction delay. 42 85


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