Vasovagal Syncope
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton
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]
Triggers[edit | edit source]
Include
- Prolonged standing
- Emotional stress
- Pain
- The sight of blood
- Fear of needles
- Time varying magnetic field, for example transcranial magnetic stimulation)
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)