Long-term orthostatic and bicycle exercise tests in differential diagnosis of syncopal conditions of unclear origin


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Abstract

Aim. To study efficiency of bicycle exercise test and long-term orthostatic test in differential diagnosis
of syncopes.
Material and methods. The study included 113 patients suffering from recurrent syncopes of unclear
origin. Twelve healthy volunteers were selected for assessment of the tests specificity. All the patients
and controls were examined by means of long-term orthostatic test (LTOT) and bicycle exercise test
(BET).
Results. Specificity of both tests was 100%,. In LTOT syncopes were observed in 52(46%) cases, including
vasovagal syncopes (51 patients), epileptic seizure (1 patient). BET induced vasovagal syncopes
in 54(48%) patients. The results of both tests by inducing syncopes coincided in 30 (26%) cases.
In 24(21%o) patients syncopes occurred only in BET while LTOT appeared uninformative. In 21
(18.6%) cases syncopes occurred only in LTOT while BET produced a negative result. 38 (34%) patients
had syncopes neither in LTOT nor BET. Both tests induced syncopes in 75 (66%) patients. No
complications were observed.
Conclusion. LTOT and BET are safe and complementary methods in differential diagnosis of syncopes.

References

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