Vasovagal Syncope: What is it?
Quite a lot of people (if not almost everyone) experienced an episode of syncope at least once in their lives. It is not surprising because syncope, which stands for a fainting or a loss of consciousness, is rather a common symptom. Generally, a person who has had a fainting fit recover very quickly, and there is no special high risk after the episode of faint has finished.
Nevertheless, some types of syncope can be really dangerous. So it is very important for physicians to determine with total accurateness what kind of this particular case is, whether it poses a hazard to human life and what an adequate treatment is. It is essential to predict the cases that can lead to a sudden death.
The causes of syncope can be grouped into four major categories vasomotor, neurologic, metabolic, and cardiac. Among them only cardiac syncope usually has a fatal outcome.
In our article we will talk about vasovagal syncope (the other name of it is cardioneurogenic syncope) that is the most common cause of syncope. On its part falls about more than 80% of all syncopal episodes. As vasovagal syncope is a normal neurological reflex, yet exaggerated a bit, the majority of people had at least one vasovagal episode of syncope in their lifetimes.
What can provoke vasovagal episodes? Among the most common triggers the specialists outline the following:
- Standing up very quickly;
- Prolonged standing or upright sitting, especially if one stands with legs in a locked position for long periods of time (that is the situation that is taught in the military as well as in marching bands and drill teams);
- Vomiting or nausea;
- Hyperthermia, the condition of having a body temperature greatly above normal;
- Random onsets due to nerve malfunctions;
- Abdominal straining or “bearing down”;
- Swallowing (generally known as swallowing syncope) or coughing (generally known as cough syncope);
- Urination (generally known as micturition syncope) or defecation, having a bowel movement (generally known as defecation syncope);
- Intense laughter;
- Using of definite drugs that affect blood pressure, for example, amphetamine;
- High temperature, either environment or as a result of some work or exercise;
- High altitude;
- Cold water with the temperature less than 50° Fahrenheit or 10° Celsius, or ice that comes in contact with the face;
- Pressing upon certain places on the throat, sinuses, and eyes, also known as vagal reflex stimulation when performed clinically;
- Stress and any sudden onset of extreme emotions;
Some unpleasant or painful situations that can involve the following conditions:
- Watching someone to experience pain
- Watching or experiencing some medical procedures
- Giving a blood donation or watching the procedure someone give it
- Sight of blood
- Giving or receiving a needle immunization.
- Dental and eye examinations
In addition to the mentioned above situations, there are some other situations that are likely to lead to syncope. Among them really serious problems can occur such as the problems with cardiovascular system and so on. So it is quite obvious that the diagnosis is made correctly. If the patient is adequate and remembers the fact of losing the conscience and the reason of vasovagal syncope, a doctor can diagnose just by asking questions and bringing the clear answers into correlation with his or her medical knowledge. So the heart of the diagnosis of vasovagal syncope lies into a clear description by the patient of typical triggers, symptoms, and how much time syncope lasted.
In assistance to physicians there are some diagnostic tests that can improve the diagnostic accuracy of the cases of recurrent vasovagal syncope. They are as follows:
- An echocardiogram
- A tilt table test
- A Holter monitor or event monitor
- Implantation of an insertable loop recorder
- An Electrophysiology study
Treatment for vasovagal syncope is based on avoidance of the causes of the condition and measures that interrupt or prevent the pathophysiologic mechanism described above. Here we need to know what the trigger of syncope is.
As vasovagal syncope leads to a decrease in blood pressure, it is not very favorable to make the entire body relaxed as a way of vasovagal syncope avoidance. A patient is also likely to make his or her legs crossed and tighten leg muscles to keep blood pressure from dropping so drastically before an injection is made.
Three general methods of therapy for vasovagal syncope are generally known. They are educational methods, drugs, and pacemakers. Choosing between three of them, an educational way is by far the best and the most effective.
The person who tends to have periodic vasovagal syncopes should be aware of some facts:
Vasovagal syncope is made by a reflex that causes sudden dilation of the blood vessels in the legs, causing the blood to pool there.
Any condition that leads to dehydration of the organism is likely to make a person more tend to vasovagal syncope.
Your insurer might up your rates, depending on the details of your health insurance policy contract.
The majority of people usually have a brief period of the symptoms that precede and indicate to a soon loss of consciousness. It is a specific warning of the organism which can be used to prevent the episode.
In order to take preventive measures, a person should lie down and raise his or her legs when feeling any precaution syndrome of a soon syncopal episode.
There are particular days or periods of weeks when a person is more prone to having a syncopal episode.
If a person understands these five facts and is able to put them to work, he or she will avoid syncope. If this does not seriously reduce the syncopes, talk to your doctor or contact your health insurance company for information on what they advise you to undertake.
Some patients experience vasovagal syncope with disturbing frequency even if all appropriate precautions are made. These patients should try a drug therapy. If a person wants to find the appropriate drug treatment, it is a matter of trial and error. Nevertheless, some drugs are reported to be quite effective and reduce about 60 - 70% of the episodes. Among these drugs doctors frequently prescribe medicines with beta blockers, serotonin uptake inhibitors, florinef, midodrine and so on. A person need to consulate with his or her physician.
What concerns pacemakers, they are used for patients with the cardioinhibitory form of vasovagal syncope. In these cases implantation of a permanent pacemaker may be not only beneficial but even curative.
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