Global cerebral hypoperfusion resulting in syncope, and asynchronous discharge of cerebral neurons leading to seizure, are two major mechanisms of transient loss of consciousness. They both have a lot in common in clinical and historical settings, although with a high prevalence of incorrect diagnosis, even by well-trained staff. The aim of this review was to try to combine data from both a car...

The importance of cardiac output (CO) to blood pressure level during vasovagal syncope is unknown. We measured thermodilution CO, mean blood pressure (MBP), and leg muscle mean sympathetic nerve activity (MSNA) each minute during 60 degrees head-up tilt in 26 patients with recurrent syncope. Eight patients tolerated tilt (TT) for 45 min (mean age 60 +/- 5 yr) and 15 patients developed syncope d...

INTRODUCTION Syncope is a common presentation of sinus node dysfunction (SND). Some patients who receive a permanent pacemaker due to SND do not benefit from it and further diagnostic workup leads to the diagnosis of vasovagal syncope (VVS). The aim of the study was to identify electrophysiological criteria that can be used for identification of patients with SND and concurrent VVS. MATERIAL ...

Vasovagal syncope (neurocardiogenic syncope) is considered the most common cause of repetitive syncope [1]. Severe pain, emotional stress, anxiety, erect postural change in a patient who is in a hypovolemic state, invasive medical procedures such as intravenous catheter insertion, venipuncture and neuraxial anesthesia are regarded as triggering factors for this syndrome. Additionally, the resul...

The vasovagal response is characterized by an inappropriate combination of bradycardia and paradoxical vasodilation. During a general or neuraxial anesthesia-induced sympathectomy, a sudden vagal activation and/or an acute reduction in sympathetic tone can cause serious vasovagal responses. Neuraxial anesthesia for Cesarean section may trigger vasovagal response, due to multiple risk factors; h...

BACKGROUND Posture-related vasovagal syncope is by far the most frequent cause of transient loss of consciousness, and present pharmacological and cardiac pacing treatment remains unsatisfactory. A simple maneuver to prevent or diminish vasovagal reactions would be beneficial. METHODS AND RESULTS Twenty-one patients with recurrent syncope (age 17 to 74 years, 11 males) who were referred for r...

the follow-up (from 3 to 2 and 0), simply after evaluating them, performing the tilt table test and explaining the pathogenesis of the disease. This fact may explain Dr. Sra’s (2) skepticism on the medical capacity to prove the benefit of any treatment for vasovagal syncope. This could also be the reason why almost any treatment that has been tested for the therapy of vasovagal syncope has been...

BACKGROUND Due to lack of efficacy in recent trials, current guidelines for the treatment of neurally-mediated (vasovagal) syncope do not promote cardiac pacemaker implantation. However, the finding of asystole during head-up tilt -induced (pre)syncope may lead to excessive cardioinhibitory syncope diagnosis and treatment with cardiac pacemakers as blood pressure is often discontinuously measur...