Vasovagal Syncope: Difference between revisions
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== Introduction == | == Introduction == | ||
Vasovagal syncope (VVS), also known as neurocardiogenic or reflex syncope, is caused by a sudden drop in blood pressure, often triggered by a reaction to something. VVS is the most common form of syncope, and although usually harmless, its frequent occurrence adversely affects quality of life and increase the risk of adverse events<ref>Longo S, Legramante JM, Rizza S, Federici M. [https://www.sciencedirect.com/science/article/abs/pii/S0953620523000973 Vasovagal syncope:] An overview of pathophysiological mechanisms. European Journal of Internal Medicine. 2023 Apr 6.Available: https://www.sciencedirect.com/science/article/abs/pii/S0953620523000973<nowiki/>(accessed 4.5.2024)</ref>. Diagnosis and management of vasovagal syncope is hard as the differential diagnoses are manyfold. In most cases vasovagal syncope is treated conservatively.<ref>Jeanmonod R, Sahni D, Silberman M. [https://www.ncbi.nlm.nih.gov/books/NBK470277/ Vasovagal Episode]. StatPearls. Treasure Island (FL).Available:https://www.ncbi.nlm.nih.gov/books/NBK470277/ (accessed 3.5.2024)</ref> | Vasovagal syncope (VVS), also known as neurocardiogenic or reflex [[syncope]], is caused by a sudden drop in [[Hypotension|blood pressure]], often triggered by a reaction to something. VVS is the most common form of syncope, and although usually harmless, its frequent occurrence adversely affects [[Quality of Life|quality of life]] and increase the risk of adverse events<ref>Longo S, Legramante JM, Rizza S, Federici M. [https://www.sciencedirect.com/science/article/abs/pii/S0953620523000973 Vasovagal syncope:] An overview of pathophysiological mechanisms. European Journal of Internal Medicine. 2023 Apr 6.Available: https://www.sciencedirect.com/science/article/abs/pii/S0953620523000973<nowiki/>(accessed 4.5.2024)</ref>. Diagnosis and management of vasovagal syncope is hard as the differential diagnoses are manyfold. In most cases vasovagal syncope is treated conservatively.<ref>Jeanmonod R, Sahni D, Silberman M. [https://www.ncbi.nlm.nih.gov/books/NBK470277/ Vasovagal Episode]. StatPearls. Treasure Island (FL).Available:https://www.ncbi.nlm.nih.gov/books/NBK470277/ (accessed 3.5.2024)</ref> | ||
== Epidemiology == | == Epidemiology == | ||
VVS, the most common form of syncope in adults, is the cause of 85% of syncopal events in people younger than 40 years. In older persons, more than half of syncopal episodes are due to VVS. VVS needs a working autonomic nervous system its occurrence is low in those with autonomic nervous system dysfunction, eg Parkinson disease. Lifetime incidence a VVS is more than 33%.<ref name=":0">Jeanmonod R, Sahni D, Silberman M. [https://www.ncbi.nlm.nih.gov/books/NBK470277/ Vasovagal Episode]. StatPearls. Treasure Island (FL).Available:https://www.ncbi.nlm.nih.gov/books/NBK470277/ (accessed 4.5.2024)</ref> | |||
* VVS, the most common form of syncope in adults, is the cause of 85% of syncopal events in people younger than 40 years. | |||
* In older persons, more than half of syncopal episodes are due to VVS. VVS needs a working [[Autonomic Nervous System|autonomic nervous system]] its occurrence is low in those with autonomic nervous system dysfunction, eg [[Parkinson's|Parkinson disease]]. | |||
* Lifetime incidence a VVS is more than 33%.<ref name=":0">Jeanmonod R, Sahni D, Silberman M. [https://www.ncbi.nlm.nih.gov/books/NBK470277/ Vasovagal Episode]. StatPearls. Treasure Island (FL).Available:https://www.ncbi.nlm.nih.gov/books/NBK470277/ (accessed 4.5.2024)</ref> | |||
== Management == | == Management == | ||
VVS is on the whole treated conservatively. If known and avoidable, patients need to avoid triggers. Patients are may need to drink more fluids to improve their volume status and to slowly change positions. If the patient experiences "warning signs" of a VVS educate them to place themselves in a supine position if they feel an imminent event. Most patients with VVS have a history of a syncopal prodrome. Patients may describe a feeling of lightheadedness, feelings of warmth and nausea, tunnel vision, ringing in their ears, and profuse sweating. Preventative strategies at this stage will often prevent a VVS event by preventing traumatic risk from a fall. In refractory or disabling cases and cases of prolonged asystole, cardiac pacing is a therapeutic option.<ref name=":0" /> | VVS is on the whole treated conservatively. | ||
* If known and avoidable, patients need to avoid triggers. | |||
* Patients are may need to drink more fluids to improve their volume status and to slowly change positions. If the patient experiences "warning signs" of a VVS educate them to place themselves in a supine position if they feel an imminent event. | |||
* Most patients with VVS have a history of a syncopal prodrome. Patients may describe a feeling of lightheadedness, feelings of warmth and nausea, tunnel vision, ringing in their ears, and profuse sweating. | |||
* Preventative strategies at this stage will often prevent a VVS event by preventing traumatic risk from a fall. | |||
* In refractory or disabling cases and cases of prolonged asystole, [[Cardiac Implantable Electronic Devices (CIEDs)|cardiac pacing]] is a therapeutic option.<ref name=":0" /> | |||
== | == Education Affected Persons == | ||
* Recognise warning symptoms and immediately: | |||
* Sit down or lie flat when possible with legs eg on top of a pillow, or up against a wall or chair. | |||
* Clench and unclench your fistsor squeeze the leg and buttock muscles. | |||
* Quick action may prevent the episode. | |||
* Get up cautiously when you feeling ok, but be prepared to sit down promptly if symptoms return. | |||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 07:52, 4 May 2024
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Introduction[edit | edit source]
Vasovagal syncope (VVS), also known as neurocardiogenic or reflex syncope, is caused by a sudden drop in blood pressure, often triggered by a reaction to something. VVS is the most common form of syncope, and although usually harmless, its frequent occurrence adversely affects quality of life and increase the risk of adverse events[1]. Diagnosis and management of vasovagal syncope is hard as the differential diagnoses are manyfold. In most cases vasovagal syncope is treated conservatively.[2]
Epidemiology[edit | edit source]
- VVS, the most common form of syncope in adults, is the cause of 85% of syncopal events in people younger than 40 years.
- In older persons, more than half of syncopal episodes are due to VVS. VVS needs a working autonomic nervous system its occurrence is low in those with autonomic nervous system dysfunction, eg Parkinson disease.
- Lifetime incidence a VVS is more than 33%.[3]
Management[edit | edit source]
VVS is on the whole treated conservatively.
- If known and avoidable, patients need to avoid triggers.
- Patients are may need to drink more fluids to improve their volume status and to slowly change positions. If the patient experiences "warning signs" of a VVS educate them to place themselves in a supine position if they feel an imminent event.
- Most patients with VVS have a history of a syncopal prodrome. Patients may describe a feeling of lightheadedness, feelings of warmth and nausea, tunnel vision, ringing in their ears, and profuse sweating.
- Preventative strategies at this stage will often prevent a VVS event by preventing traumatic risk from a fall.
- In refractory or disabling cases and cases of prolonged asystole, cardiac pacing is a therapeutic option.[3]
Education Affected Persons[edit | edit source]
- Recognise warning symptoms and immediately:
- Sit down or lie flat when possible with legs eg on top of a pillow, or up against a wall or chair.
- Clench and unclench your fistsor squeeze the leg and buttock muscles.
- Quick action may prevent the episode.
- Get up cautiously when you feeling ok, but be prepared to sit down promptly if symptoms return.
References[edit | edit source]
- ↑ Longo S, Legramante JM, Rizza S, Federici M. Vasovagal syncope: An overview of pathophysiological mechanisms. European Journal of Internal Medicine. 2023 Apr 6.Available: https://www.sciencedirect.com/science/article/abs/pii/S0953620523000973(accessed 4.5.2024)
- ↑ Jeanmonod R, Sahni D, Silberman M. Vasovagal Episode. StatPearls. Treasure Island (FL).Available:https://www.ncbi.nlm.nih.gov/books/NBK470277/ (accessed 3.5.2024)
- ↑ 3.0 3.1 Jeanmonod R, Sahni D, Silberman M. Vasovagal Episode. StatPearls. Treasure Island (FL).Available:https://www.ncbi.nlm.nih.gov/books/NBK470277/ (accessed 4.5.2024)
