Zastosowanie próby pionizacyjnej w diagnostyce omdleń u dzieci

Piotr Wieniawski, *Bożena Werner, Katarzyna Gryszko

Summary
Tilt test is the most important and useful method for diagnosing vasovagal syncope.
It is being performed in children with suspicion of neurocardiogenic syncope and standard history of vasovagal reaction, after excluding other reasons of syncope (such as cardiogenic syncope or neurological causes).
Passive tilt test is the most commonly used form of tilt tests while drug induced active tilt test is rarely used in medical practice.
The authors describe methodology and indications of passive tilt test and discus interpretation of its result.
The end result of tilt test is to induce reactive decrease in blood pressure, bradycardia or delayed ortostatic reaction leading to syncope or pre-syncope condition.
VASIS (Vasovagal Syncope International Study) classification of tilt test induced syncope differentiates: type 1 – mixed type of vasovagal reaction; type 2 – cardiodepressive type of vasovagal reaction; type 3 – vasodepressive type of neurocardiogenic syncope.
Tilt test is being used in therapy of syncope during so called 'tilt training' – a method of treatment consisting of repeated use of tilt tests. Negative tilt test does not exclude vasovagal syncope.
Patient's history and tilt test results (in selected cases) remain the most important and usually sufficient method of diagnosing vasovagal syncope.

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