Worsening of symptoms before presentation with vasovagal syncope.
BACKGROUND
Much of the natural history of vasovagal syncope is unknown. We determined whether patients presenting for care have had a recently worsened syncope frequency.


RESULTS
We compared 208 subjects in the referral-based Prevention of Syncope Trial (POST) and 122 subjects who fainted > or =1 in a community survey study. Their mean ages and gender proportions were similar. The POST population had a higher median lifetime syncope frequency (1.16 vs 0.12 spells/year, P < 0.0001) and more subjects began fainting at age > or =35 years (26% vs 6%, P < 0.0001). In POST, the median frequency of syncopal spells in the preceding year was higher than in all previous years (3 vs 0.57, P < 0.0001). POST subjects presented sooner after their first spell (median 11.0 vs 16.8 years, P = 0.0002), and after their last spell (median 0.3 vs 7.4 years, P < 0.0001). POST subjects > or =35 years old had a shorter history than similar community-survey subjects (2.8 vs 14.9 y, P < 0.0001) and presented earlier after their first syncopal spell than POST subjects with a younger onset of syncope (median 2.8 vs 14.7 y, P < 0.0001), despite having fewer faints (median 6 vs 10, P = 0.0002).


CONCLUSIONS
Many syncope patients present for care after a recent worsening of their frequency of syncope.
Sheldon
Robert S
RS
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada. sheldon@ucalgary.ca
Sheldon
Aaron G
AG
Serletis
Anna
A
Connolly
Stuart J
SJ
Morillo
Carlos A
CA
Klingenheben
Thomas
T
Krahn
Andrew D
AD
Koshman
Mary-Lou
ML
Ritchie
Debbie
D
D000328:Adult; D017668:Age of Onset; D002170:Canada / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome