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Manlio F Márquez, Jorge Rafael Gómez-Flores, Jesús A González-Hermosillo, Teresita de Jesús Ruíz-Siller, Manuel Cárdenas
Vasovagal or neurocardiogenic syncope is a common clinical situation and, as with other entities associated with orthostatic intolerance, the underlying condition is a dysfunction of the autonomic nervous system. This article reviews various aspects of vasovagal syncope, including its relationship with orthostatic intolerance and the role of the autonomic nervous system in it. A brief history of the problem is given, as well as a description of how the names and associated concepts have evolved. The response of the sympathetic system to orthostatic stress, the physiology of the baroreflex system and the neurohumoral changes that occur with standing are analyzed...
December 29, 2016: Medwave
Jameel Ahmed, Peerawut Deeprasertkul, Kevin M Monahan, Paul LeLorier
BACKGROUND: Syncope is a common problem in the general population and results in significant societal and patient costs. Several small studies have demonstrated differences in orthostatic response, and possibly tolerance, between blacks and whites. Based on these observations, we retrospectively reviewed results from our tilt table database to identify potential differences in response to tilt-table testing with regards to race, between black and white patients. METHODS: The reports of 446 tilt-table tests performed on adults, older than 18 years of age, at Boston Medical Center, an urban, tertiary-care, academic hospital, were reviewed...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Mohammed T Numan, Ankur Kamdar, Jane Young, Ian J Butler
Postural orthostatic tachycardia syndrome and neurocardiogenic syncope are clinical manifestations of autonomic nervous system dysfunction (dysautonomia) that can lead to impaired daily functions. We report two young patients presenting with dysautonomia and autoimmune disease who both received autologous adipose stem cells (ASCs) infusions. This report is the first description of ASCs therapy for patients with combined dysautonomia and autoimmune disease. Case 1: A 21-year-old female presented at 12 years of age with escalating severe dysautonomia with weight loss and gastrointestinal symptoms...
March 15, 2017: Stem Cells and Development
Dong-Hyuk Lee, Kyung-Min Lee, Jung-Min Yoon, Jae-Woo Lim, Kyung-Ok Kho, Hong-Ryang Kil, Eun-Jung Cheon
PURPOSE: Neurocardiogenic syncope (NCS) is the most frequent cause of fainting during adolescence. Inappropriate cardiovascular autonomic control may be responsible for this clinical event. The head-up tilt test has been considered a diagnostic standard, but it is cumbersome and has a high false-positive rate. We performed a study to evaluate whether P-wave dispersion (PWD) could be a useful electrocardiographic parameter of cardiac autonomic dysfunction in children with NCS. METHODS: Fifty-four patients with NCS (28 boys and 26 girls; mean age, 12...
November 2016: Korean Journal of Pediatrics
Yashwant Agrawal, Jagadeesh K Kalavakunta, Vishal Gupta, William Lapenna
We report a case of a 26-year-old woman who presented with multiple episodes of syncope over a five-months period of time. Transthoracic echocardiogram had shown a normal functioning quadricuspid aortic valve (QAV) which was also confirmed on a transesophageal echocardiogram. Computed tomographic angiography of heart and coronary arteries showed the QAV with equal size of all aortic cusps and normal coronary arteries. Intermittent chest pain and palpitations warranted an exercise stress test. The stress test revealed normal aerobic exertion, with achievement of 101% of maximal peak heart rate...
2016: Case Reports in Cardiology
Cathríona R Monnard, Jean-Pierre Montani, Erik K Grasser
BACKGROUND AND PURPOSE: Energy drinks (EDs) are suspected to induce potential adverse cardiovascular effects and have recently been shown to reduce cerebral blood flow velocity (CBFV) in young, healthy subjects. Gender differences in CBFV in response to EDs have not previously been investigated, despite the fact that women are more prone to cardiovascular disturbances such as neurocardiogenic syncope than men. Therefore, the aim of this study was to explore gender differences in cerebrovascular and cardiovascular responses to EDs...
2016: Frontiers in Physiology
Aleksandra Gergont, Beata Gajda, Ewa Wesołowska
BACKGROUND: Despite the signs of involvement of autonomic nervous system (ANS) in the pathomechanism of migraine, the significance of its dysfunction was not fully explained. One of parameters serving to establish a balance of both ANS parts is relation of low frequency (LF) to high frequency (HF) heart rate variability (HRV), LF/ HF ratio. HF reflects parasympathetic activity, whereas LF both sympathetic and parasympathetic as well as respiratory rhythm. AIMS: The aims of the study was to establish LF and HF ratio in children with migraine with aura, during rest, passive tilting and also during active standing...
2016: Przegla̧d Lekarski
Aleksandra Gergont, Katarzyna Kurdziel, Urszula Stolarska-Weryńska
BACKGROUND: Neurocardiogenic syncope, the most common episodic event in children results from global cerebral hypoperfusion. Monitoring of the blood flow during head-up tilt-induced syncope resulted in registration of preferential reduction of end-diastolic velocities in middle cerebral arteries (MCA). The significance of those changes was however not explained. The aim of this retrospective research was to establish the significance of visual inspection of spectra changes of cerebral blood flow in MCA during presyncope and syncope in children...
2016: Przegla̧d Lekarski
Ha Son Nguyen, Harvey Woehlck, Peter Pahapill
Background. Symptomatic bradycardia and hypotension in neurosurgery can produce severe consequences if not managed appropriately. The literature is scarce regarding its occurrence during deep brain stimulation (DBS) surgery. Case Presentation. A 67-year-old female presented for left DBS lead placement for essential tremors. During lead implantation, heart rate and blood pressure dropped rapidly; the patient became unresponsive and asystolic. Chest compressions were initiated and epinephrine was given. Within 30 seconds, the patient became hemodynamically stable and conscious...
2016: Case Reports in Neurological Medicine
Teresa Grimaldi Capitello, Caterina Fiorilli, Silvia Placidi, Roberta Vallone, Fabrizio Drago, Simonetta Gentile
BACKGROUND: Health-related quality of life, which can be investigated using self-reports or parental reports, could help healthcare providers understand the subjective perception of well-being of children suffering from recurrent syncopal episodes. Quality of life is not only a measure of health but is also a reflection of patients' and parents' perceptions and expectations of health. This study assessed: 1) the consistency and agreement between pediatric patients' self-reports and parents' proxy-reports of their child's quality of life; 2) whether this patient-parent agreement is dependent on additional demographic and clinical or distress factors; 3) whether the parents' psychological distress influences children's and parents' responses to questionnaires on quality of life...
May 17, 2016: Health and Quality of Life Outcomes
Emre Demir, Can Hasdemir, Handan Ak, Sevcan Atay, Hikmet Hakan Aydin
Neurocardiogenic syncope (NCS) is the most frequent type of syncope characterized by a self-limited episode of systemic hypotension. In this study, we conducted the first genome-wide association study testing copy number variations for association with NCS. Study population consisted of 107 consecutive patients with recurrent syncope and positive head-up tilt table testing. Four families with NCS were selected for CNV analysis. Affymetrix GeneChip(®) SNP 6.0 array was used for CNV analysis. Data and statistical analysis were performed with Affymetrix genotyping console 4...
August 2016: Biochemical Genetics
Krzysztof Błaszyk, Adrian Gwizdała, Wojciech Seniuk, Michał Waśniewski, Stefan Grajek
No abstract text is available yet for this article.
2016: Kardiologia Polska
Nicholay Teodorovich, Moshe Swissa
A tilt table test (TTT) is an inexpensive, noninvasive tool for the differential diagnosis of syncope and orthostatic intolerance and has good diagnostic yield. The autonomic system malfunction which underlines the reflex syncope is manifested as either hypotension or bradycardia, while an orthostatic challenge is applied. The timing of the response to the orthostatic challenge, as well as the predominant component of the response help to differentiate between various forms of neurocardiogenic syncope, orthostatic hypotension and non-cardiovascular conditions (e...
March 26, 2016: World Journal of Cardiology
Biswajit Sinha, Dinesh K Dubey
BACKGROUND: The cold pressor test (CPT) is a recognized physiological technique to evaluate autonomic cardiovascular function. The present case study assessed the cardiovascular response of a healthy adult male during 3 min of CPT. METHODS: Heart rate (HR) by single-lead electrocardiography and blood pressure (BP) by an arterial tonometer of the participant on a beat-to-beat basis were recorded before and during CPT. RESULTS: HR during CPT showed a biphasic pattern with an initial increase from baseline (86 bpm) to the first 30 s of CPT (93 bpm) followed by a decrease...
June 1, 2016: Journal of Basic and Clinical Physiology and Pharmacology
Julien Fromonot, Guillaume Chaumet, Olivier Gavarry, Jean-Claude Rostain, Michel Lucciano, Fabrice Joulia, Michele Brignole, Jean-Claude Deharo, Regis Guieu, Alain Boussuges
Head-up tilt test is useful for exploring neurally mediated syncope. Adenosine is an ATP derivative implicated in cardiovascular disturbances that occur during head-up tilt test. The aim of the present study was to investigate the impact of hyperoxia on adenosine plasma level and on hemodynamic changes induced by head-up tilt testing.Seventeen healthy male volunteers (mean age 35 ± 11 years) were included in the study. The experiment consisted of 2 head-up tilt tests, 1 session with subjects breathing, through a mask, medical air (FiO2 = 21%) and 1 session with administration of pure oxygen (FiO2 = 100%) in double-blind manner...
February 2016: Medicine (Baltimore)
Mathieu Courtheix, Zakaria Jalal, Pierre Bordachar, Xavier Iriart, Xavier Pillois, Cécile Escobedo, Catherine Rabot, Laetitia Tribout, Jean-Benoit Thambo
BACKGROUND: Syncopes are frequent in the paediatric population. Most are benign, but rare cases are caused by cardiac life-threatening diseases. Syncope units developed in the adult population have demonstrated improvement in evaluation and treatment, with a reduction in hospitalization. AIMS: We report our experience of paediatric syncope management in a dedicated unit, and analyse the value of different elements in the identification of cardiac causes. METHODS: This prospective study included 97 consecutive patients (mean age: 12...
March 2016: Archives of Cardiovascular Diseases
Mehrdad Saravi, Alijan Ahmadi Ahangar, Mohammad Masood Hojati, Ebrahim Valinejad, Ahmad Senaat, Reza Sohrabnejad, Mohammad Reza Khosoosi Niaki
BACKGROUND: Syncope is a common clinical problem which can be remarkably debilitating and associated with high health care costs. Syncope is a clinical syndrome with many potential causes. The aim of the study was to determine the etiologies of patients with syncope in the emergency department (ED) of a referral and general university hospital. METHODS: One hundred sixty-five consecutive patients aged more than 18 years old with syncope were admitted to the emergency department of Ayatollah Rouhani Hospital...
2015: Caspian Journal of Internal Medicine
Bradley D Brown, Theodore Rais
The relationship between autism spectrum disorders and mitochondrial dysfunction, including mitochondrial myopathies and other mitochondrial diseases, is an area of ongoing research. All autism spectrum disorders are known to be heritable, via genetic and/or epigenetic mechanisms, but specific modes of inheritance are not well characterized. Nevertheless, autism spectrum disorders have been linked to many specific genes associated with mitochondrial function, especially to genes involved in mitochondrial tRNA and the electron transport chain, both particularly vulnerable to point mutations, and clinical research also supports a relationship between the two pathologies...
September 2015: Innovations in Clinical Neuroscience
Rezvan Noormand, Akbar Shafiee, Gholamreza Davoodi, Fatemeh Tavakoli, Alireza Gheini, Ahmad Yaminisharif, Arash Jalali, Saeed Sadeghian
BACKGROUND: The head-up tilt test (HUTT) is a useful diagnostic tool for syncope. OBJECTIVES: We sought to investigate the outcome of the HUTT in syncope patients and identify the relationship between age and different hemodynamic outcomes. PATIENTS AND METHODS: In this cross-sectional study, we prospectively enrolled consecutive patients who presented with syncope and underwent the HUTT with a clinical suspicion of neurocardiogenic syncope after the exclusion of orthostatic hypotension cases...
November 2015: Research in Cardiovascular Medicine
Khalil Kanjwal, Hugh Calkins
Most strategies for managing syncope in children reflect data from studies involving the adult population. In the future, there will be a great need for studies in children and adolescents suffering from recurrent syncope. To date, there has been no Food and Drug Administration-approved therapy for neurocardiogenic syncope (NCS), the most common cause of syncope in both adults and children. None of the clinical trials of pharmacotherapy in NCS has shown benefit over placebo. NCS should be considered a chronic condition, and the aim of the therapy should be to decrease recurrence of syncope rather than to completely eliminate it...
August 2015: Cardiology Clinics
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