Historial evolution of diagnosis criteria

pp 143-154

Abstract

Since the beginning of history of medicine syncopal episodes caused differencial diagnosis difficulties. Foremost neurological causes from cardiovascular ones were kept apart. Afterwards, within the latter, those due to Adams-Stokes syndrome from the ones caused by valvular disease or by vagus inhibitory action (vasovagal syncope). Electrocardiographic development allowed precise diagnosis between AV block and tachy- or brady-arrhythmias, as well as to demonstrate that changes in QRS morphology (Wolff-Parkinson-White syndrome) or Q-T interval (Jervell and Lang-Nielsen or Romano-Ward syndrome) were eventually capable or triggering arrhythmias leading to syncopal episodes. At the onset of space flights, on returning to Earth syncope is the most apparent sign of gravitational maladjustment syndrome.