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Vasovagal syncope

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https://www.readbyqxmd.com/read/28721322/etiology-and-age-distribution-of-syncope-in-a-predominantly-african-american-population
#1
Ahmad Awan, Hasan Iftikhar, Fasil Tiruneh, Shahabuddin Soherwardi, Daniel Larbi
BACKGROUND: Syncope, the sudden transient loss of consciousness due to multiple etiologies, usually has worse outcomes in African Americans compared with other races because of other comorbidities. This study aims to identify a correlation between the etiologies of syncope and age in a predominantly African-American sample population to facilitate future investigations with potentially improved specificity to address this condition. METHODS: We reviewed the medical records of 155 patients who presented with syncope concerns to the emergency department at our university hospital...
June 14, 2017: Curēus
https://www.readbyqxmd.com/read/28718664/short-term-complications-for-percutaneous-ultrasound-guided-biopsy-of-renal-masses-in-adult-outpatients
#2
Lars René Rasmussen, Martina Loft, Tommy Kjærgaard Nielsen, Marie Bjødstrup Jensen, Søren Høyer, Arne Hørlyck, Ole Graumann
Background Ultrasound-guided percutaneous kidney tumor biopsy (UGPKB) plays an important role in the diagnosis of renal tumor but there are no consensuses with respect to the length and the extend of the post-biopsy observation period. Purpose To assess the short-term complication rate after UGPKB and to evaluate whether the onset of complications allows for the procedure to be performed in an outpatient setting with same-day discharge. Material and Methods Between March 2012 and March 2014, a total of 287 UGPKB were performed in an outpatient setting at a Danish university referral center...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28710604/pacing-and-vasovagal-syncope-back-to-our-physiologic-roots
#3
EDITORIAL
Robert S Sheldon, Satish R Raj
No abstract text is available yet for this article.
July 14, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28699049/the-target-of-vasovagal-syncope-is-hemostasis-and-not-heart-protection
#4
EDITORIAL
Rolf R Diehl
No abstract text is available yet for this article.
July 11, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28681121/indexes-of-cerebral-autoregulation-do-not-reflect-impairment-in-syncope-insights-from-head-up-tilt-test-of-vasovagal-and-autonomic-failure-subjects
#5
Pedro Castro, João Freitas, Rosa Santos, Ronney Panerai, Elsa Azevedo
PURPOSE: The study of dynamic cerebral autoregulation (CA), which adapts cerebral blood flow to arterial blood pressure (ABP) fluctuations, has been limited in orthostatic intolerance syndromes, mainly due to its stationary prerequisites hardly to meet during maneuvers to provoke syncope itself. New techniques of continuous estimates of CA could overcome this pitfall. We aimed to evaluate CA during head-up tilt test in common conditions causing syncope. METHODS: We compared three groups: eight controls; eight patients with autonomic failure due to familial amyloidotic polyneuropathy; eight patients with vasovagal syncope (VVS)...
July 5, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28674628/syndromes-of-orthostatic-intolerance-and-syncope-in-young-adults
#6
Viktor Hamrefors, Jasmina Medic Spahic, David Nilsson, Martin Senneby, Richard Sutton, Olle Melander, Artur Fedorowski
OBJECTIVE: To explore the clinical and neuroendocrine characteristics of syndromes of orthostatic intolerance and syncope in young adults. METHODS: Two hundred and thirty-six patients aged 18-40 years with orthostatic intolerance and/or syncope were examined by head-up tilt test (HUT). Plasma levels of epinephrine, norepinephrine, renin, C-terminal-pro-arginine-vasopressin (CT-proAVP), C-terminal-endothelin-1 and mid-regional-fragment of pro-atrial-natriuretic-peptide (MR-proANP) were analysed...
2017: Open Heart
https://www.readbyqxmd.com/read/28669088/vasovagal-syncope-with-asystole-the-role-of-cardiac-pacing
#7
REVIEW
Michele Brignole, Marco Tomaino, Alessio Gargaro
Whereas cardiac pacing has a very limited role overall in patients with vasovagal syncope (VVS), there are three reasons which support pacing efficacy in tilt-induced asystolic VVS. These are: (1) contrary to mixed and vasodepressor forms, an asystolic tilt response is specific, i.e., diagnostic, of VVS and is unlikely to occur in control patients without history of syncope and in patients with cardiac syncope; (2) contrary to mixed and vasodepressor forms, an asystolic tilt response predicts a similar asystolic event during prolonged ECG monitoring with a positive predictive value of 86%; (3) the available evidence from trials supports the efficacy of dual-chamber pacing with a low recurrence rate of syncope after pacing ranging from 6% up to 23% during 3 years of follow-up...
July 1, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28669087/typical-vasovagal-syncope-as-a-defense-mechanism-for-the-heart-by-contrasting-sympathetic-overactivity
#8
REVIEW
Paolo Alboni, Marco Alboni
Many observations suggest that typical (emotional or orthostatic) vasovagal syncope (VVS) is not a disease, but rather a manifestation of a non-pathological trait. Some authors have hypothesized this type of syncope as a "defense mechanism" for the organism and a few theories have been postulated. Under the human violent conflicts theory, the VVS evolved during the Paleolithic era only in the human lineage. In this evolutionary period, a predominant cause of death was wounding by a sharp object. This theory could explain the occurrence of emotional VVS, but not of the orthostatic one...
July 1, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28662832/vascular-causes-of-syncope-an-emergency-medicine-review
#9
Brit Long, Alex Koyfman
BACKGROUND: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. OBJECTIVE: This review evaluates vascular causes of syncope and their evaluation and management in the ED. DISCUSSION: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention...
June 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28649180/procoagulatory-changes-induced-by-head-up-tilt-test-in-patients-with-syncope-observational-study
#10
Viktor Hamrefors, Artur Fedorowski, Karin Strandberg, Richard Sutton, Nazim Isma
BACKGROUND: Orthostatic hypercoagulability is proposed as a mechanism promoting cardiovascular and thromboembolic events after awakening and during prolonged orthostasis. We evaluated early changes in coagulation biomarkers induced by tilt testing among patients investigated for suspected syncope, aiming to test the hypothesis that orthostatic challenge evokes procoagulatory changes to a different degree according to diagnosis. METHODS: One-hundred-and-seventy-eight consecutive patients (age, 51 ± 21 years; 46% men) were analysed...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28617840/a-new-test-for-diagnosing-vasovagal-syncope-standing-after-treadmill-test-with-sublingual-nitrate-administration
#11
Tae-Hoon Kim, Ho-Jun Jang, Sihun Kim, Sung Yun Cho, Kyung Sun Song, Christopher Pickett, Heiko J Schmitt, Juyong Lee
INTRODUCTION: Increased adrenergic tone might be an additional trigger of orthostatic stress of vasovagal syncope (VVS). Exercise before standing might provide increased sensitivity compared to standing using a sublingual nitroglycerines protocol during tilt table testing. The aim of this study was to evaluate the diagnostic value of treadmill testing before standing with nitroglycerin administration. METHODS AND RESULTS: A total of 36 patients with syncope or presyncope were enrolled for the test...
2017: PloS One
https://www.readbyqxmd.com/read/28616731/renal-nerve-stimulation-for-treatment-of-neurocardiogenic-syncope-a-review-from-perspective-of-commercialization-potential
#12
REVIEW
B O'Brien, H Zafar, F Sharif
A strong evidence of outcomes for vasovagal syncope is not easily identified. It would seem reasonable that the proposed Mayo Clinic technology would be reserved for cases with severe recurrent or refractory syncope. However, recurrence levels are relatively low, and while some predictive methods have been proposed, recurrence is also influenced by the interaction that occurs during screening and examinations, i.e. recurrence diminishes once an initial diagnosis has been made. Finally, a key factor in being able to identify suitable patients relates to understanding the relative significance of the vasodepression and cardioinhibitory components-the therapy is best suited to patients that have a significant level of both components...
June 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28606501/childhood-trauma-and-lifetime-syncope-burden-among-older-adults
#13
Celia O'Hare, Cathal McCrory, Neil O'Leary, Helen O'Brien, Rose Anne Kenny
OBJECTIVE: Vasovagal syncope is governed by the autonomic nervous system and often precipitated by highly salient emotional situations. We hypothesized that a lifetime tendency towards vasovagal syncope may be precipitated by exposure to childhood trauma. METHODS: We examined data from the first wave of The Irish Longitudinal Study on Ageing (TILDA) of adults aged 50+ (n=6497) who were asked to report lifetime syncope frequency and any history of childhood sexual or physical abuse...
June 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28585146/deceleration-capacity-a-novel-measure-for-autonomic-nervous-system-in-patients-with-vasovagal-syncope-on-tilt-table-testing
#14
Fen Huang, Chun-Fang Xu, Xiao-Yan Deng, Ping Zuo, Fan Lin, Jing-Jing Fan, Wen-Jia Xu, Xiao-Yun Yang
This study was to investigate the changes of autonomic nerve function and hemodynamics in patients with vasovagal syncope (VVS) during head-up tilt-table testing (HUT). HUT was performed in 68 patients with unexplained syncope and 18 healthy subjects served as control group. According to whether bradycardia, hypotension or both took place during the onset of syncope, the patients were divided during the test into three subgroups: vasodepressor syncope (VD), cardioinhibitory syncope (CI) and mixed syncope (MX) subgroups...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28558089/analysis-of-heart-rate-variability-before-and-during-tilt-test-in-patients-with-cardioinhibitory-vasovagal-syncope
#15
Cláudia Madeira Miranda, Rose Mary Ferreira Lisboa da Silva
BACKGROUND: Cardioinhibitory vasovagal response is uncommon during the tilt test (TT). Heart rate variability (HRV) by use of spectral analysis can distinguish patients with that response. OBJECTIVE: To compare the HRV in patients with cardioinhibitory vasovagal syncope (case group - G1) with that in patients without syncope and with negative response to TT (control group - G2). METHODS: 64 patients were evaluated (mean age, 36.2 years; 35 men) and submitted to TT at 70 degrees, under digital Holter monitoring...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28554964/decreasing-cerebral-oxygen-consumption-during-upright-tilt-in-vasovagal-syncope
#16
Marvin S Medow, Mira L Kothari, Amanda M Goetz, Mary Breige O'Donnell-Smith, Courtney Terilli, Julian M Stewart
We measured changes in transcranial Doppler ultrasound (TCD) and near infrared spectroscopy (NIRS) during 70° upright tilt in patients with recurrent vasovagal syncope (VVS, N = 20), postural tachycardia syndrome (POTS, N = 20), and healthy controls (N = 12) aged 15-27 years old. VVS was included if they fainted during testing within 5-15 min of upright tilt. We combined TCD and NIRS to obtain estimates of percent change in the cerebral metabolic rate of oxygen consumption (CMRO2), cerebral blood flow velocity (CBFv), and oxygen extraction fraction (OEF)...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28504781/expanding-the-evidence-base-in-the-pharmacological-management-of-vasovagal-syncope-the-next-post
#17
J Davison
No abstract text is available yet for this article.
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28501796/nitric-oxide-synthase-inhibition-restores-orthostatic-tolerance-in-young-vasovagal-syncope-patients
#18
Julian M Stewart, Richard Sutton, Mira L Kothari, Amanda M Goetz, Paul Visintainer, Marvin Scott Medow
OBJECTIVE: Syncope is sudden transient loss of consciousness and postural tone with spontaneous recovery; the most common form is vasovagal syncope(VVS). We previously demonstrated impaired post-synaptic adrenergic responsiveness in young VVS patientswas reversed by blocking nitric oxide synthase(NOS). We hypothesised that nitric oxide may account for reduced orthostatic tolerance in young recurrent VVS patients. METHODS: We recorded haemodynamics in supine VVS and healthy volunteers (aged 15-27 years), challenged with graded lower body negative pressure (LBNP) (-15, -30, -45 mm Hg each for 5 min, then -60 mm Hg for a maximum of 50 min) with and without NOS inhibitor N(G)-monomethyl-L-arginine acetate(L-NMMA)...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28496928/idiopathic-paroxysmal-atrio-ventricular-block-what-is-the-mechanism
#19
REVIEW
Francisco J Guerrero-Márquez, Eduardo Arana-Rueda, Alonso Pedrote
Idiopathic paroxysmal atrioventricular (AV) block poses a true diagnostic challenge. What is clear about this entity is the confusion about its definition and consequently about its etiology. According to certain sources, the diagnosis of this block requires the lack of a structural cardiac pathology that justifies the observed manifestations and an absence of electrocardiographic disorders prior to an episode. The clinical presentation of idiopathic paroxysmal AV block does not differ from that of another cardiogenic syncope or of a vasovagal syncope with a significant cardioinhibitory component...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28488555/-syncope-suspect-pulmonary-embolism-especially-in-the-elderly
#20
W Opstelten, F L J Visseren
Syncope can be caused by a pulmonary embolism. This applies in particular to elderly patients admitted with syncope; in the general population, however, syncope is far more frequently caused by a vasovagal response or orthostatic hypotension. Syncope can be the symptom of a pulmonary embolism, even in the absence of any clinical manifestations of this diagnosis; it is, therefore, important to exclude pulmonary embolism in any syncope patient in the accident and emergency department by applying the Wells clinical decision rule...
2017: Nederlands Tijdschrift Voor Geneeskunde
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