RT Journal Article
SR Electronic
T1 Effect of aortic valve replacement on syncope in patients with aortic stenosis.
JF British Heart Journal
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 542
OP 543
DO 10.1136/hrt.70.6.542
VO 70
IS 6
A1 P T Wilmshurst
A1 P R Willicombe
A1 M M Webb-Peploe
YR 1993
UL http://heart.bmj.com/content/70/6/542.abstract
AB OBJECTIVE--To determine the role of exertion as a precipitating factor in syncope in patients with aortic stenosis. DESIGN--Follow up for at least one year after aortic valve replacement. SETTING--Regional cardiac centre. PATIENTS--Consecutive patients who underwent aortic valve replacement for aortic stenosis and who had a history of syncope and no other clinically significant cardiac lesion were recruited during a five year period. METHODS--Patients were interviewed to determine the characteristics of syncope and were divided into those in whom syncope was consistently related to exertion (group 1, 26 patients) and those in whom it was not (group 2, 13 patients). Recurrence of syncope after valve replacement was determined at visits to the clinic. RESULTS--Groups 1 and 2 did not differ significantly with respect to valve area, age, or sex. In 13 of the 26 patients in group 1 syncope was preceded by angina despite the absence of coronary artery disease, but none of the 13 patients in group 2 had angina. After valve replacement none of group 1 and eight of the 13 patients in group 2 had recurrence of syncope (p < 0.01). CONCLUSION--When patients with aortic stenosis experience syncope unrelated to exertion, the symptom is usually unrelated to the valve disease and another cause should be sought.