A patient with a documented history of 2 asystolic episodes associated with venipuncture demonstrates the profound cardioinhibitory effects that vasovagal reactions to blood and injury ("blood-injury phobia") can produce. In approaching a patient with blood-injury phobia, the clinician should place the patient in the Trendelenburg position, apply a cardiac monitor, administer oxygen, and consid...

We reviewed the charts of 100 patients admitted to the hospital for evaluation of syncope. The charts were examined with special attention given to the causes of syncope, the frequency and benefit of diagnostic tests, and the relative cost of these tests. In 39 patients no etiology for syncope was found, and another 18 were felt to have had a vasovagal episode. Twelve patients had arrhythmias a...

Undiagnosed syncope is always a perplexing and challenging diagnostic problem that clinician face daily. Vasovagal syncope (VVS) remains the most common cause of syncope especially in the absence of significant structural heart disease and ECG abnormalities. Syncope is a frequent cause of consultation and accounts for about 3% of Emergency room admissions and 1% to 6% hospital admissions in the...

Syncope is a sudden transient loss of consciousness with loss of postural tone, followed by spontaneous recovery1. Around 30 percent of the general population have one syncopal event in their lifetime, with 3% having recurrent episodes2. Vasovagal syncope (VVS) is an exaggerated tendency towards the common faint that accounts for up to 29% of syncope3 and affects all age groups. VVS is characte...

References 1. Rose MS, Koshman ML, Spreng S, Sheldon R. The relationship between health-related quality of life and frequency of spells in patients with syncope. J Clin Epidemiol 2000;53:1209–16. 2. van Dijk N, Boer KR, Weiling W, Linzer M, Sprangers MA. Validity and responsiveness of the Syncope Functional Status Questionnaire. J Gen Int Med 2007;22:1280–5. 3. Rose MS, Koshman M-L, Ritchie D, ...

Sample entropy (SampEn) was reported to be useful in the assessment of the complexity of heart rate dynamics. Permutation entropy (PermEn) is a new measure based on the concept of order and was previously shown to be accurate for short, non-stationary datasets. The aim of the present study is to assess if SampEn and PermEn obtained from baseline recordings might differentiate patients with vari...

Syncope is defined as transient loss of consciousness as a result of cerebral hypoperfusion. Electroencephalography during syncope shows either a 'slow-flat-slow' or a 'slow' pattern. The first is believed to denote more severe hypoperfusion. Although the diagnosis of vasovagal syncope relies primarily on history taking, there is limited evidence regarding the relative importance of various cli...

BACKGROUND Syncope accounts for about 1-2% of emergency department visits, but the etiology in many patients with syncope is unclear. Recently, with the use of the head-up tilt test (HUT), the number of patients with unexplained syncope (UPS) has been decreasing; however, the spectrum of underlying diseases of syncope in children is unclear. This retrospective study aimed to analyze the spectru...

Vasovagal syncope can be confused with epileptic seizure. In this situation, eye compression may be performed during EEG. We present a video-EEG of a patient in whom eye compression produced a typical syncope. Before this recording, the patient had been treated for five years with sodium valproate because of a misdiagnosis of epilepsy. The diagnosis of neurally-mediated syncope was not difficul...