Modern methods of diagnostics of syncopal conditions in servicemen

Abstract

The review article is devoted to modern methods of diagnosing syncope, which is becoming more and more common among young people every year. This article discusses the causes and mechanisms of syncope, as well as methods of diagnosing and differentiating it. Particular attention is paid to syncope that occurs as a result of orthostatic hypotension. Unfortunately, syncope has long been ignored by both doctors and patients. It is not uncommon for patients to ignore isolated episodes of loss of consciousness, explaining them by lifestyle features. A long absence of any diagnosis, and, as a consequence, treatment leads to the progression of the underlying disease that provokes this syncope. But the problem of diagnosing syncope depends not only on patients, but also on doctors. Due to the lack of a clear algorithm that allows for accurate diagnosis of syncope and differentiation, doctors’ diagnostic capabilities are limited. However, this is not the only problem, since the lack of special equipment in most medical institutions also affects the quality of syncope diagnostics. Tilt test is currently the gold standard in syncope diagnostics according to the 2018 European Society of Cardiology recommendations. The equipment is expensive, and the diagnostic ability of this method does not provide the desired results for diagnosis verification. Today, the attitude to this problem is changing and in 2023, the development of a plan of clinical recommendations of the Russian Society of Cardiology began, where syncope is highlighted in a separate chapter. Accurate diagnostics of syncope is needed not only to determine the underlying disease. In the clinical practice of a doctor, there are often cases of simulation of syncope by young people of draft age for personal purposes. It is practically impossible to clinically confirm the presence of syncope in the past at the moment (especially if it was a single episode of loss of consciousness). The lack of a clear algorithm significantly complicates the verification of the diagnosis. The purpose of writing this article was to study the most effective diagnostic methods that allow you to most accurately determine the cause of syncope.

Keywords

cardiogenic syncope / diagnostic methods / neurogenic syncope / orthostatic hypotension / Shellong test / Syncopal states / tilt-test

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