[Importance of tilt-table testing compared with Schellong's test for the diagnosis of orthostatic dysregulations/syncopes].
OBJECTIVE
The study compares the importance of tilt-table testing and Schellong's test for the diagnosis of syncopes.


METHODS
In a prospective clinical trial 100 consecutive patients (45 males, 55 females) were included. The index symptom for inclusion was a former syncope or presyncope in the patients' history. The tilt-table testing procedure was performed according to a modified version of the Westminster protocol. Following this procedure, Schellong's test was performed in 83 of the patients.


RESULTS
During tilt-table testing 34 patients suffered from orthostatic dysautonomy with syncope or neuro-cardiogenic syncope. 29 of these symptomatic patients also underwent Schellong's test. However, only four patients showed a borderline positive finding, whereas a clearly positive result was seen in six patients. These patients had shown orthostatic dysautonomies with syncopes during tilt-table testing. No patient suffered from a syncope or presyncope during Schellong's test.


CONCLUSIONS
Schellong's test is suitable as a diagnostic procedure for orthostatic dysregulation only, and tilt-table testing is highly superior for objectification of the diagnosis and differentiation of syncope.
Jungblut
Sven
S
Medizinische Klinik, St. Katharinen Krankenhaus, Frankfurt/Main.
Frickmann
Hagen
H
Römer
Albrecht
A
Gilfrich
Hans Joachim
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013575:Syncope / Q000209:etiology*; D019462:Syncope, Vasovagal / Q000175:diagnosis*; D018667:Tilt-Table Test