Naslov
Neurally mediated syncope

Autori
Ljilja, Anja ; Mišmaš, Antonija ; Adamec, Ivan ; Habek, Mario

Izvornik
Neurologia Croatica (0353-8842) 62 (2013); 3-10

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
bradycardia, head-up tilt table test, hypotension, neurally mediated syncope

Sažetak
Neurally mediated or vasovagal syncope is the most common cause of transient loss of consciousness. Too excessive response to different triggers (emotional stress, scenes of blood, prolonged standing, etc.) results in brief and self-limiting loss of consciousness caused by a sudden drop in blood pressure with or without heart rate drop, which leads to transient brain hypoxia. Prior to the episode of syncope, the patient can have a sensation of nausea, sweating, pallor, and visual field narrowing. Although it is known that in the syncope background there is dysregulation of blood pressure control, the pathophysiology is still unclear. Blood pressure regulation involves complex afferent signals from the aortic arch processed by the central nervous system and efferent modulation of the heart and vascular system. Vasovagal syncope usually does not require treatment. However, in some cases to rule out other causes of fainting, such as arrhythmias, a broad diagnostic work-up is required, for which head-up tilt table test is most commonly used. Frequent vasovagal syncope adversely affects patient’s quality of life and pharmacological treatment with β- blockers, such as metoprolol, selective serotonin reuptake inhibitors and vascular constrictors like α-agonists can be administered. Other techniques to reduce hypotension are foot exercise, compressive stockings, increased fluid and salt intake. In more serious cases of vasovagal syncope with bradycardia or asystole, insertion of the electric pacemaker is an option.

Izvorni jezik
Engleski

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