title: Are syncopes in sitting and supine positions different? Body positions and syncope: a study of 111 patients.
abstract: BACKGROUND
  Syncope is a common cause of transient loss of consciousness. In the analysis of patients having syncope, body position has not been systematically studied and correlated with triggers, prodromal symptoms and circumstances. This correlation is important in differentiating syncope from its mimics.
  
  
  OBJECTIVE
  To study syncope with respect to body positions, triggers, prodromal symptoms and circumstances.
  
  
  METHODS
  Prospective study set in Neurology Department of Tertiary Care Center.
  
  
  METHODS
  Patients fulfilling guidelines set by The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC) were recruited. Detailed clinical history, examination and investigations (ECG, 2D-ECHO, Head Up Tilt Test, Holter monitor, EEG, MRI Brain) were carried out.
  
  
  RESULTS
  Out of the 111 recruited patients, 67 developed syncope in standing, 16 in sitting, 23 in both standing and sitting, 1 in both sitting and supine and 4 in all three positions. Prodromal symptoms were present in 81% while triggers in 42% and circumstances in 41% of patients. Black out, sweating, dizziness and headache were most common prodromal symptoms. Intense pain, smell and fear were most common triggers while prolonged standing, hot crowded room and fasting were most common circumstances associated with syncope.
  
  
  CONCLUSIONS
  Against common belief, syncope can occur in sitting as well as in supine position. Emotional triggers were commoner in patients with syncope in supine and sitting positions while prodromal symptoms and circumstances were similar for all positions. Syncope should be considered in body positions other than standing.
authors.affiliation: Department of Neurology, Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Byculla, Mumbai, Maharashtra, India. khadilkarsatish@gmail.com
authors.forename: Satish V
authors.initials: SV
authors.lastname: Khadilkar
authors.forename: Rakhil S
authors.initials: RS
authors.lastname: Yadav
authors.forename: Kamlesh A
authors.initials: KA
authors.lastname: Jagiasi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D062706:Prodromal Symptoms; D011446:Prospective Studies; D016683:Supine Position / Q000502:physiology; D013575:Syncope / Q000209:etiology / Q000503:physiopathology