「失神」を主訴に入院，精査された87例の臨床的検討

Clinical features in 87 patients with syncope

　失神とは中枢神経系の虚血に基づく，一過性で短時問の意識消失発作を意味する。

　失神の原因には，血管迷走神経反射性失神や起立性低血圧等の比較的"良性"と思われるものから，放置すれば死に至る重篤な不整脈に基づくものまで種々の病態が含まれる。したがって，個々の失神患者の基礎疾患や病態を十分に把握し，治療方針を立てることが重要であるが，本邦では失神に関する詳細な臨床像の検討はなされていない。

Clinical features were analysed in 87 patients (40 males and 47 females with average age of 56 years old) hospitalized for evaluation of syncopal episode. Fifty-six cases (65%) were cardiovascular, 16 cases (18%) noncardiovascular and 15 cases (17%) unknown in etiology. Among cardiovascular syncope, 23 had sick sinus syndrome, 23 atrio-ventricular (AV) block, 8 ventricular tachycardia, 1 aortic stenosis and 1 pulmonary hypertension. Etiological disease in 23 patients with AV block was unknown (degeneration or aging process) in 16, ischemic heart disease (vasos-pastic angina or acute myocardial infarction) in 6, and acute myocarditis in 1, respectively. Permanent pace-maker was implanted in 32 patients of 42 with sick sinus syndrome and AV block. Five patients (6.4%) were died, and 4 out of 5 suddenly within one year.