{"id":445,"date":"2012-07-08T12:40:40","date_gmt":"2012-07-08T09:40:40","guid":{"rendered":"http:\/\/www.hvtd.org\/?p=445"},"modified":"2012-07-08T12:40:40","modified_gmt":"2012-07-08T09:40:40","slug":"norokardiyojenik-vasovagal-senkop-olgu","status":"publish","type":"post","link":"https:\/\/www.hvtd.org\/?p=445","title":{"rendered":"N\u00f6rokardiyojenik (Vasovagal) Senkop – Olgu"},"content":{"rendered":"

\"\"<\/a>Olgu:<\/strong> 37 ya\u015f\u0131nda F\/O, erkek. B\u00fcy\u00fck ticari kargo u\u00e7a\u011f\u0131 sim\u00fclat\u00f6r u\u00e7u\u015fu sonras\u0131nda aniden v\u00fccudunda seyirmeler olup yere y\u0131k\u0131lm\u0131\u015f; bu s\u0131rada istemsiz kas spazmlar\u0131 olmu\u015f. Yard\u0131m\u0131na ko\u015fan arkada\u015flar\u0131 ba\u015f\u0131n\u0131 korumaya al\u0131p, s\u0131rt\u00fcst\u00fc yat\u0131rm\u0131\u015flar. 1 dakika i\u00e7inde sorulan sorulara uygun ve do\u011fru cevaplar verebilecek durumda imi\u015f. Ama olanlar\u0131 ve bay\u0131l\u0131p yere d\u00fc\u015ft\u00fc\u011f\u00fcn\u00fc hat\u0131rlam\u0131yormu\u015f. Biraz sonra rengi solmu\u015f, tekrar kas seyirmeleri ve bacaklar\u0131nda b\u00fck\u00fclme olmu\u015f; 1 dak. sonra tekrar kendine gelmi\u015f. Muayenesine gelen acil servis doktoruna, bay\u0131lman\u0131n ba\u015f d\u00f6nmesi ve g\u00f6rme alan\u0131nda \u0131\u015f\u0131k u\u00e7u\u015fmalar\u0131 ile ba\u015flad\u0131\u011f\u0131n\u0131, diz\u00fcst\u00fc \u00e7\u00f6k\u00fcnce d\u00fczeldi\u011fini, aya\u011fa kalk\u0131nca tekrarlad\u0131\u011f\u0131n\u0131 s\u00f6ylemi\u015f.<\/p>\n

Muayene:<\/strong> Serebellar testler normal, Romberg (-), motor-duyusal kusur yok, CT: Normal, Kan tahlilleri: Normal, EEG: Normal, Holter EKG: Normal. Ekokardiyografi: Normal. Efor testinde 21 dakikal\u0131k Bruce protokol\u00fcn\u00fc m\u00fckemmel bi\u00e7imde tamamlad\u0131\u011f\u0131 ve EKG\u2019ye yans\u0131yan patolojik bulgu olmad\u0131\u011f\u0131 belirlenmi\u015f. 6 ay sonraki kardiyolojik de\u011ferlendirmede de semptom bulunmam\u0131\u015f.<\/p>\n

\u00d6ntan\u0131:<\/strong> Beyin cerrahi uzman\u0131, epileptik olmayan konvulsif senkop d\u00fc\u015f\u00fcnerek ila\u00e7 \u00f6nermemi\u015f.<\/p>\n

Havac\u0131l\u0131k t\u0131bb\u0131 de\u011ferlendirmesi:<\/strong> Bu olguda, \u015fahit olunan presenkop d\u0131\u015f\u0131nda klinik-laboratuvar bulgu olmamas\u0131 y\u00fcz\u00fcnden tan\u0131 ve karar zorlu\u011fu vard\u0131r. Ya\u015fanan olay\u0131n bir epileptik n\u00f6bet mi, yoksa bir basit senkop mu oldu\u011fu \u015f\u00fcphelidir. Miyoklonik kas\u0131lmalar n\u00f6bet olas\u0131l\u0131\u011f\u0131n\u0131 akla getirmi\u015f; bilin\u00e7 kayb\u0131 olmamas\u0131 ve semptomlar\u0131n \u00e7ok \u00e7abuk d\u00fczelmesi de n\u00f6rokardiyojenik (vasovagal) senkop ihtimalini d\u00fc\u015f\u00fcnd\u00fcrm\u00fc\u015ft\u00fcr. Bir yanda epileptik bir olgunun yanl\u0131\u015f bi\u00e7imde senkop olarak yorumlan\u0131p u\u00e7u\u015fa verilmesi ve u\u00e7u\u015fta ge\u00e7irilecek bir n\u00f6betin feci bir kazaya neden olmas\u0131\u2026 di\u011fer yanda, bir basit senkop (presenkop) olay\u0131n\u0131n epilepsi gibi de\u011ferlendirilip, 4 y\u0131la kadar uzayabilen bir s\u00fcre boyunca u\u00e7u\u015f kesilmesi\u2026<\/p>\n

Sonu\u00e7:<\/strong> Bu ikilem i\u00e7inde kalan FAA Havac\u0131l\u0131k T\u0131bb\u0131 De\u011ferlendirme B\u00f6l\u00fcm\u00fc (AMCD), kanaatini olay\u0131n epileptik n\u00f6bet olmad\u0131\u011f\u0131 y\u00f6n\u00fcnde kulland\u0131. Pilota hi\u00e7bir k\u0131s\u0131tlama koymadan 1. S\u0131n\u0131f t\u0131bbi sertifika verdi.<\/p>\n","protected":false},"excerpt":{"rendered":"

Olgu: 37 ya\u015f\u0131nda F\/O, erkek. B\u00fcy\u00fck ticari kargo u\u00e7a\u011f\u0131 sim\u00fclat\u00f6r u\u00e7u\u015fu sonras\u0131nda aniden v\u00fccudunda seyirmeler olup yere y\u0131k\u0131lm\u0131\u015f; bu s\u0131rada istemsiz kas spazmlar\u0131 olmu\u015f. Yard\u0131m\u0131na ko\u015fan arkada\u015flar\u0131 ba\u015f\u0131n\u0131 korumaya al\u0131p, s\u0131rt\u00fcst\u00fc yat\u0131rm\u0131\u015flar. 1 dakika i\u00e7inde sorulan sorulara uygun ve do\u011fru cevaplar verebilecek durumda imi\u015f. Ama olanlar\u0131 ve bay\u0131l\u0131p yere d\u00fc\u015ft\u00fc\u011f\u00fcn\u00fc hat\u0131rlam\u0131yormu\u015f. Biraz sonra rengi solmu\u015f, tekrar kas seyirmeleri ve bacaklar\u0131nda […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-445","post","type-post","status-publish","format-standard","hentry","category-bulten"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/445","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=445"}],"version-history":[{"count":1,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/445\/revisions"}],"predecessor-version":[{"id":447,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=\/wp\/v2\/posts\/445\/revisions\/447"}],"wp:attachment":[{"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=445"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=445"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hvtd.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=445"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}