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QJM Advance Access published online on January 9, 2008
QJM, doi:10.1093/qjmed/hcm140
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Self-reported symptom burden; outcome in 418 patients from the Newcastle Vasovagal (Neurocardiogenic) cohort

R. Ross1, S. Parry1, M. Norton1 and J.L. Newton1,2

From the 1Falls and Syncope Service, Royal Victoria Infirmary and 2Institute of Cellular Medicine, School of Clinical Medical Sciences, University of Newcastle, UK

Address correspondence to Dr Julia L. Newton, Falls and Syncope Service/Cardiovascular Investigation Unit, University of Newcastle, Royal Victoria Infirmary, Newcastle NE1 4LP, UK. email: julia.newton{at}nuth.nhs.uk

Received 16 August 2007 and in revised form 22 October 2007


  Abstract

Background: Natural history of Vasovagal syndrome (Neurocardiogenic; NCS) is unclear.

Aim: To examine symptoms in a large cohort with head up tilt diagnosed NCS.

Methods: Questionnaires were posted to 485 patients with NCS. Data included demographic details, age at referral, presenting and on-going symptoms (syncope, dizziness and falls), symptom frequency (daily, weekly, monthly) and burden.

Results: A total of 418 questionnaires were returned (response rate 86%), 67% female. Median age at first presentation 60 (range 10–90), with men younger (54 vs. 63; P = 0.01). Seventy percent presented with syncope. Median follow-up 5 years (1–8). At follow-up 147(35%) were asymptomatic. The asymptomatic group was older (73 vs. 65; P = 0.0001) with more males (39 vs. 29%; P = 0.04). Those presenting with syncope were more likely to be symptom-free than those with dizziness (P < 0.02). Symptom frequency was greatest for those reporting dizziness at follow-up (P < 0.05). Sixty (22%) reported symptoms never preventing activities [predominantly those reporting dizziness (P = 0.04)]. Although there was a significant reduction of symptoms overall, there was a significant increase in those reporting dizziness only (P < 0.0001).

Conclusions: Of those with NCS, 35% will be symptom-free at 5 years regardless of presenting symptom or treatment received.


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