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Vasovagal syncope

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https://www.readbyqxmd.com/read/28504781/expanding-the-evidence-base-in-the-pharmacological-management-of-vasovagal-syncope-the-next-post
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28457108/syncope-in-primary-prevention-implantable-cardioverter-defibrillator-implantation
#5
Gustavo Goldenberg, Tamir Bental, Udi Kadmon, Ronit Zabarsky, Jairo Kusnick, Alon Barsheshet, Gregory Golovchiner, Boris Strasberg
BACKGROUND: Syncope prognosis varies widely: 1 year mortality may range from 0% in the case of vasovagal events up to 30% in the presence of heart disease. OBJECTIVES: To assess the outcomes and prognosis of patients with implantable cardiac defibrillator (ICD) and indication of primary prevention and compare patients presenting with or without prior syncope. METHODS: We reviewed the charts of 75 patients who underwent ICD implantation with the indication of primary prevention and history of syncope and compared them to a control group of 80 patients without prior syncope...
January 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28456564/respiratory-and-hemodynamic-contributions-to-emotion-related-pre-syncopal-vasovagal-symptoms
#6
Johanna M Harrison, Philippe T Gilchrist, Tiana S Corovic, Curtis Bogetti, Yuqing Song, Simon L Bacon, Blaine Ditto
Vasovagal reactions are conventionally understood as resulting from systemic changes in cardiovascular activity; however, there exists a complementary perspective focused on specific changes in cerebral vasoconstriction associated with hyperventilation-induced hypocapnia. The present study investigated the role cardiovascular and respiratory activity in self-reported pre-syncopal vasovagal reactions to a surgery video in a sample a 49 healthy women. Participants who indicated more previous real-life episodes of dizziness reported experiencing significantly more symptoms in the laboratory consistent with a vasovagal response...
April 26, 2017: Biological Psychology
https://www.readbyqxmd.com/read/28429690/-our-experience-in-the-diagnosis-and-treatment-of-postural-orthostatic-tachycardia-syndrome-vasovagal-syncope-and-inappropriate-sinus-tachycardia-in-children
#7
Sezen Ugan Atik, Reyhan Dedeoğlu, Aida Koka, Funda Öztunç
OBJECTIVES: The aim of this study was to share our experience in the diagnosis and treatment of patients who presented at our clinic with syncope, pre-syncope, dizziness, and palpitations. STUDY DESIGN: Patients who were treated at pediatric cardiology clinic for complaints of syncope, dizziness, and palpitations between 2014 and 2016 were enrolled in the study. Detailed history of the patients, physical examination findings, laboratory and electrocardiogram results were recorded...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28422288/general-dentists-awareness-of-how-to-cope-with-medical-emergencies-in-paediatric-dental-patients
#8
Ivana Čuković-Bagić, Sandra Hrvatin, Jesenka Jeličić, Dubravka Negovetić Vranić, Mirjana Kujundžić Tiljak, Hrvoje Pezo, Luc Marks
BACKGROUND: General dentists (GDs) should be aware of the symptoms, signs, diagnoses and treatment of medical emergencies in paediatric patients. AIM: To evaluate the knowledge of GDs in coping with medical emergencies, and to identify whether they are confident to diagnose and treat medical emergencies in paediatric patients. DESIGN: The questionnaire was conducted immediately before the beginning of national dental meetings and continuing education seminars in Croatia, attended by the GDs, in order to obtain a representative sample...
April 19, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28407148/effects-of-closed-loop-stimulation-vs-ddd-pacing-on-haemodynamic-variations-and-occurrence-of-syncope-induced-by-head-up-tilt-test-in-older-patients-with-refrac-tory-cardioinhibitory-vasovagal-syncope-the-tilt-test-induced-response-in-closed-loop-stimulation
#9
Pietro Palmisano, Gabriele Dell'Era, Vincenzo Russo, Maria Zaccaria, Rolando Mangia, Miriam Bortnik, Federica De Vecchi, Ailia Giubertoni, Fabiana Patti, Andrea Magnani, Gerardo Nigro, Anna Rago, Eraldo Occhetta, Michele Accogli
Aims: Closed-loop stimulation (CLS) seemed promising in preventing the recurrence of vasovagal syncope (VVS) in patients with a cardioinhibitory response to head-up tilt test (HUTT) compared with conventional pacing. We hypothesized that the better results of this algorithm are due to its quick reaction in high-rate pacing delivered in the early phase of vasovagal reflex, which increase the cardiac output and the blood pressure preventing loss of consciousness. Methods and results: This prospective, randomized, single-blind, multicentre study was designed as an intra-patient comparison and enrolled 30 patients (age 62...
April 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28403704/nursing-management-of-reflex-anoxic-seizures-in-children
#10
Neal Patel, Rowan Kerr-Liddell, Louise Challis, Siba Prosad Paul
Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy...
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28360882/vestibular-activation-habituates-the-vasovagal-response-in-the-rat
#11
Bernard Cohen, Giorgio P Martinelli, Yongqing Xiang, Theodore Raphan, Sergei B Yakushin
Vasovagal syncope is a significant medical problem without effective therapy, postulated to be related to a collapse of baroreflex function. While some studies have shown that repeated static tilts can block vasovagal syncope, this was not found in other studies. Using anesthetized, male Long-Evans rats that were highly susceptible to generation of vasovagal responses, we found that repeated activation of the vestibulosympathetic reflex (VSR) with ±2 and ±3 mA, 0.025 Hz sinusoidal galvanic vestibular stimulation (sGVS) caused incremental changes in blood pressure (BP) and heart rate (HR) that blocked further generation of vasovagal responses...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28351847/differentiating-between-postural-tachycardia-syndrome-and-vasovagal-syncope
#12
Jeffrey B Anderson, Martha W Willis
No abstract text is available yet for this article.
March 28, 2017: Pediatrics
https://www.readbyqxmd.com/read/28351846/postural-heart-rate-changes-in-young-patients-with-vasovagal-syncope
#13
Marvin S Medow, Sana Merchant, Melissa Suggs, Courtney Terilli, Breige O'Donnell-Smith, Julian M Stewart
BACKGROUND AND OBJECTIVES: Recurrent postural vasovagal syncope (VVS) is caused by transient cerebral hypoperfusion from episodic hypotension and bradycardia; diagnosis is made by medical history. VVS contrasts with postural tachycardia syndrome (POTS), defined by chronic daily symptoms of orthostatic intolerance with excessive upright tachycardia without hypotension. POTS has recently been conflated with VVS when excessive tachycardia is succeeded by hypotension during tilt testing. We hypothesize that excessive tachycardia preceding hypotension and bradycardia is part of the vasovagal response during tilt testing of patients with VVS...
March 28, 2017: Pediatrics
https://www.readbyqxmd.com/read/28345114/peripheral-endothelial-function-after-arterial-switch-operation-for-d-looped-transposition-of-the-great-arteries
#14
Heather Y Sun, Katie Jo Stauffer, Susan E Nourse, Chau Vu, Elif Seda Selamet Tierney
Coronary artery re-implantation during arterial switch operation in patients with D-looped transposition of the great arteries (D-TGA) can alter coronary arterial flow and increase shear stress, leading to local endothelial dysfunction, although prior studies have conflicting results. Endothelial pulse amplitude testing can predict coronary endothelial dysfunction by peripheral arterial testing. This study tested if, compared to healthy controls, patients with D-TGA after arterial switch operation had peripheral endothelial dysfunction...
March 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28341843/multistructure-index-characterization-of-heart-rate-and-systolic-blood-pressure-reveals-precursory-signs-of-syncope
#15
Danuta Makowiec, Beata Graff, Zbigniew R Struzik
Recurrent syncope - abrupt loss of consciousness - can have a serious impact on patients' quality of life, comparable with chronic illnesses. Vasovagal syncope (VVS) is a specific reflex syncope, in which an inappropriate reaction of the autonomic nervous system (ANS) plays a key role in the pathophysiology. In syncope diagnosis, an ideal diagnostic method should positively identify vasovagal sensitive patients, without the need to perform a specialised head-up tilt table (HUTT) test. We apply a novel methodology of multistructure index (MI) statistics for seamlessly evaluating the size spectrum of the asymmetry properties of magnitudes of neural reflexes responsible for maintaining the homeostatic dynamics of autonomic control...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28333901/influence-of-the-recurrent-syncope-episodes-on-neurocognitive-functions-in-patients-with-vasovagal-syncope
#16
Joanna Jędrzejczyk-Spaho, Artur Z Pietrucha, Agnieszka Borowiec, Irena Bzukała, Mateusz Wnuk, Ewa Konduracka, Jadwiga Nessler
The aim of study was to evaluate an influence of recurrent syncope episodes on the neurocognitive functions (NCF) in patients with suspected VVS. AIM: The aim of study was to evaluate an influence of recurrent syncope episodes on the neurocognitive functions (NCF) in patients with suspected VVS. MATERIALS AND METHODS: Study population: 24 pts. (16 women) aged 17-70 yrs (mean age 40 years), with suspected VVS, referred to HUTT (head-up tilt test). All pts. underwent initial evaluation regarding to the number and circumstances of the syncopal and/or presyncopal spells...
March 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28294432/should-we-treat-severe-vasovagal-syncope-with-a-pacemaker
#17
REVIEW
R Sutton
Cardiac pacing for vasovagal syncope (VVS) addresses the cardioinhibitory component of the reflex but cannot directly affect vasodepression, which occurs in every reflex even when hidden by dominant cardioinhibition. The randomized controlled trials of pacing in VVS have, after almost 2 decades, determined that a small number of patients can benefit because their vasodepressor component is not severe. Early studies compared pacing with no therapy yielding highly significant benefits. Subsequently, all study patients had implanted devices with half being switched off...
March 14, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28286245/pacing-as-a-treatment-for-reflex-mediated-vasovagal-situational-or-carotid-sinus-hypersensitivity-syncope-a-systematic-review-for-the-2017-acc-aha-hrs-guideline-for-the-evaluation-and-management-of-patients-with-syncope-a-report-of-the-american-college-of-cardiology
#18
Paul D Varosy, Lin Y Chen, Amy L Miller, Peter A Noseworthy, David J Slotwiner, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: To determine, using systematic review of the biomedical literature, whether pacing reduces risk of recurrent syncope and relevant clinical outcomes among adult patients with reflex-mediated syncope. METHODS: MEDLINE (through PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials (through October 7, 2015) were searched for randomized trials and observational studies examining pacing and syncope, and the bibliographies of known systematic reviews were also examined...
March 9, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28286220/pacing-as-a-treatment-for-reflex-mediated-vasovagal-situational-or-carotid-sinus-hypersensitivity-syncope-a-systematic-review-for-the-2017-acc-aha-hrs-guideline-for-the-evaluation-and-management-of-patients-with-syncope-a-report-of-the-american-college-of-cardiology
#19
Paul D Varosy, Lin Y Chen, Amy L Miller, Peter A Noseworthy, David J Slotwiner, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: To determine, using systematic review of the biomedical literature, whether pacing reduces risk of recurrent syncope and relevant clinical outcomes among adult patients with reflex-mediated syncope. METHODS: MEDLINE (through PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials (through October 7, 2015) were searched for randomized trials and observational studies examining pacing and syncope, and the bibliographies of known systematic reviews were also examined...
March 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28268420/delta-space-plot-analysis-of-cardiovascular-coupling-in-vasovagal-syncope-during-orthostatic-challenge
#20
S Reulecke, S Charleston-Villalobos, A Voss, R Gonzalez-Camarena, M Gaitan-Gonzalez, J Gonzalez-Hermosillo, G Hernandez-Pacheco, T Aljama-Corrales
In this work, a graphical method to study cardiovascular coupling, called delta space plot analysis (DSPA), was introduced. The graphical representation is susceptible to be parameterized in shape and orientation. The usefulness of this technique was studied on cardiovascular data from patients with vasovagal syncope (VVS) and from controls. The study included 15 female patients diagnosed with VVS and 11 age-matched healthy female subjects. All subjects were enrolled in a head-up tilt (HUT) test, breathing normally, including 5 minutes of supine position (baseline) and 18 minutes of 70° orthostatic phase...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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