title: A novel tilt table testing protocol for investigating patients suspected to have neurally mediated syncope.
abstract: We have observed that a series of 3 Valsalva maneuvers performed at 1-minute intervals between the 15th and 18th minute of a drug-free tilt table test resulted in intense presyncope and hypotension in a 32 yr old male with micturition syncope. In contrast, five apparently healthy subjects tolerated a 70 degree head-up tilt table test for 45 min with five Valsalva maneuvers incorporated into the testing protocol. Thus, we hypothesize that the use of a series of Valsalva maneuvers during a drug free head-up tilt table test might improve the diagnostic yield without compromising test specificity in patients suspected to have neurally mediated syncope.
authors.forename: E Sankaranarayanan
authors.initials: ES
authors.lastname: Prakash
authors.forename: P
authors.initials: P
authors.lastname: Pavithran
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013575:Syncope / Q000175:diagnosis* / Q000503:physiopathology; D018667:Tilt-Table Test; D014636:Valsalva Maneuver