Anthropometric characteristics and tilt table test results.

We appreciate the interest of Dr H. J. Koch et al. in our article and the opportunity to respond. As they state, sports medicine has become more involved in syncope and in the tilt table test. The sports medicine literature recognizes the term exerciseassociated collapse (EAC) to describe athletes who are unable to stand or walk unaided as a result of lightheadedness, feeling faint, dizziness or syncope. Also, it is recognized that syncope that occurs during exercise tends to be more ominous than that occurring in the post-exertional state. However, Calkins et al. successfully used pharmacologic therapy in 10 patients with vasodepressor syncope during or immediately after exercise, suggesting that those patients with exertional syncope might be similar to the general population with syncope, and that those patients can safely continue to participate in athletics. Finally, the data presented by Dr Koch et al. are not definitive. For example Mtinangi et al. proved that exercise training has a role in the management of patients with syncope and poor orthostatic tolerance, with improvement of symptoms and an increase in orthostatic tolerance without resting blood pressure. Nevertheless, as Dr Koch et al. point out, anthropometric characteristics that influence head-up tilt test results are rarely reported, and further studies must be designed to improve our knowledge of this frequent but obscure and unknown disease.