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Europace 2000 2(1):77-82; doi:10.1053/eupc.1999.0065
© 2000 by European Society of Cardiology
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Exercise-induced neurocardiogenic syncope

Clinical data, pathophysiological aspects, and potential role of tilt table testing

D. Kosinski, B.P. Grubb, B.J. Karas and S. Frederick

Electrophysiology Section Division of Cardiology Department of Medicine, Medical College of Ohio Toledo, Ohio, U.S.A.

The evaluation of syncope occurring during exercise or occurring spontaneously in highly trained individuals presents a unique diagnostic challenge. It is of critical importance to exclude potential life-threatening disorders such as hypertrophic cardiomyopathy, long QT syndrome, right ventricular dysplasia, anomalous coronary artery distribution, valvular heart disease, myocarditis, or exercise-induced arrhythmia. This review is not directed towards identifying, treating, or determining athletic eligibility of individuals with such disorders. Rather, we endeavour to discuss the pathophysiology of exercise-induced neurocardiogenic syncope and to address the role of head upright tilt testing in evaluating syncope in athletic individuals in whom proper evaluation has excluded the presence of ischaemic heart disease or primary structural or electrical heart disease.

Correspondence: Blair P. Grubb, MD, Division of Cardiology, Medical College of Ohio, Richard D. Ruppert Health Center, 3120 Glendale Ave., Toledo, Ohio 43614–5809 U.S.A.


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