Vasovagal syncope

No abstract text is available yet for this article.

BACKGROUND: Syncope can be caused by serious occult arrhythmias not evident during initial emergency department (ED) evaluation. We sought to develop a risk-tool for predicting 30-day arrhythmia or death after ED disposition. METHODS: We conducted a multicenter prospective cohort study at six tertiary-care EDs and included adults (≥16 years) with syncope. We collected standardized variables from clinical evaluation, and investigations including ECG and troponin at index presentation...

This article focuses on the complex interactions between the cardiovascular and neurologic systems. Initially, we focus on neurological complications in children with congenital heart disease both secondary to the underlying cardiac disease and complications of interventions. We later discuss diagnosis and management of common syncope syndromes with emphasis on vasovagal syncope. We also review the diagnosis, classification, and management of children and adolescents with postural orthostatic tachycardia syndrome...

In this correspondence the pathophysiology of reflex syncope (vasovagal syncope, carotid sinus syndrome and situational syncope) is reviewed, including clarification of the nomenclature. This article is protected by copyright. All rights reserved.

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...

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...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

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)...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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)...