A cross sectional study on prevalence and etiology of syncope in Tehran

Recurrent syncope of obscure etiology, particularly in those with structural heart diseases, is associated with higher mortality rates. There are insufficient and conflicting data on prevalence and etiology of syncope in the urban Middle Eastern population. Evaluating the etiologic basis of syncope can be an effective step in prevention of morbidities and sudden cardiac death in susceptible populations. The aim of our study was to determine the prevalence and etiology of syncope in an outpatient cardiology clinic in Tehran the capital of Iran. In this cross sectional study data was collected from patients' records whose first visits were from March 2006 to September 2007 and had undergone thorough examination for syncope (ECG, Holter monitoring, echocardiography, Tilt table testing, Electrophysiological study). All efforts were done to determine underlying heart diseases, physical exam and test abnormalities, final diagnosis and treatment in all selected patients. Overall prevalence of syncope was estimated to be 9. The age-specific prevalence rates were 5-14 years: 4.14, 15-44 years: 44.8, 45-64 years: 31, 65 years and Older: 20. The most frequently identified cause (60) was neurally-mediated (vasovagal) syncope. Mean age of patients was 44.9 years with a minimum of 5 years and maximum of 85 years. In our study, coronary heart disease had a high prevalence among participants (12.4). Syncope is a common clinical problem. In this study prevalence rates peaked in 15-44 years age group. Considering that recurrent syncope is often disabling and may cause injury and the fact that heart diseases are more common in people affected by syncope, especial cautions should be taken while evaluating this group of patients. © 2013 Tehran University of Medical Sciences. All rights reserved

Roma coronary heart disease patients have more medical risk factors and greater severity of coronary heart disease than non-Roma

<p>Coronary heart disease (CHD) is the most common cause of mortality and morbidity world-wide. Evidence on ethnic differences between the Roma and non-Roma regarding medical risk factors is scarce. The aim of this study was to assess differences in medical risk factors and the severity of CHD in Roma compared with non-Roma CHD patients, adjusted for gender, age and education.</p><p>Six hundred seventy four patients were included in this cross-sectional study (132 Roma, 542 non-Roma). Data on medical risk factors, symptoms, medication and severity of CHD were obtained from medical records. After matching Roma and non-Roma according to education, linear and logistic regression analyses with adjustments for gender and age were used.</p><p>Compared with non-Roma, Roma patients had significantly more risk factors and more severe types of CHD. They were treated less frequently with statins and beta-blockers, were more frequently left on pharmacotherapy and surgically revascularised. These differences remained after controlling for education, gender and age.</p><p>Roma CHD patients have a worse risk profile at entry of care and seem to be undertreated compared with non-Roma CHD patients.</p>