Syncope

Wayne, Howard H.

doi:10.1016/0002-9343(61)90051-1

Cited by 145 publications

(3 citation statements)

References 59 publications

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“…Our patient developed cough syncope with typical clinical signs and EEG-changes (Gastaud, 1951 cal feature was hypertension during LOC, since the common physiological changes of cough syncope are cerebral ischemia caused by a significant fall in blood pressure (Wayne, 1961). It is widely held that the increased thoracal pressure and subsequent decreased venous return to the heart causes a substantial fall in arterial blood pressure, the cerebral pressure exceeds the arterial blood pressure and cerebral ischemia occurs.…”

Section: Discussionmentioning

confidence: 73%

Cough syncope with hypertension—caused by brainstem compression?

Wieshmann

Meierkord

1995

Euro J of Neurology

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The commonly accepted pathophysiological changes in cough syncope include a fall in systemic blood pressure, raised intracranial pressure and cerebral ischemia. However, cases of cough syncope without hypotension have been reported in patients with the Arnold-Chiari malformation. We describe a 48-year old man with cough syncopes. Constant blood pressure monitoring revealed hypertension instead of the expected hypotension during the episodes. Attacks of loss of consciousness were associated with motor phenomena, i.e. tonic posturing and tonic spasm. Magnetic resonance imaging revealed compression and displacement of the medulla oblongata by an ectatic and elongated vertebral artery. The commonly accepted mechanism of cough syncope cannot explain the symptoms in our patient because a fall of blood pressure was lacking. Instead, a cough-induced compression of the displaced brainstem may have caused a transient dysfunction of the reticular formation.

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Section: Discussionmentioning

confidence: 73%

Cough syncope with hypertension—caused by brainstem compression?

Wieshmann

Meierkord

1995

Euro J of Neurology

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“…Vasovagal syncope (also known as neurocardiogenic reflex, situational syncope, or common fainting) accounts for 50 percent or more of cases presenting to the emergency department. It is the most common cause of syncope, found in approximately 20 to 35 percent of cases, particularly in patients without any apparent neurologic or cardiac disease [ 4 - 9 ]. Typical clinical features would include a precipitating event and a prodrome.…”

Section: Introductionmentioning

confidence: 99%

Association Between Baseline Blood Pressures, Heart Rates, and Vasovagal Syncope in Children and Adolescents

Adlakha

Hassan

Kern

2018

Cureus

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Background: Vasovagal syncope is the most common cause of syncope in children and adults, accounting for 50-66% of unexplained syncope. There are no studies establishing the relationship between syncope, baseline heart rate, and blood pressure.Objective: To identify a possible association between baseline blood pressure and heart rate with syncope.Design/Methods: We conducted a questionnaire-based chart review study. A questionnaire was distributed to the guardian of children between eight and 18 years of age who attended the Pediatric Ambulatory Care Clinic at Flushing Hospital Medical Center. Based on the responses in the questionnaire, subjects were classified either as cases (positive for syncope) or controls (negative for syncope). Children and adolescents with neurological, cardiac, or any medical condition that can cause syncopal episodes were excluded from the study. Data collected from the questionnaire included age, gender, ethnicity, medical history, family history of syncope, and the amount of salt used in food. Anthropometric and vital signs for the current visit (height, weight, BMI, blood pressure, and heart rate) and vital signs from two previous visits were collected from electronic medical records. The data was analyzed using t-test and chi-square test with Microsoft Excel software (Microsoft Office Standard, v. 14, Microsoft; 2010); p<0.05 was considered significant.Results: A total of 197 subjects were included in this study. There were 18 cases and 179 controls. Of the cases, (4/18) 22.2% were more likely to have a systolic blood pressure lower than the 10th percentile for their gender, age, and height as compared with controls (7/179) 3.9%, p = 0.003. The subjects with a history of syncope were more likely to add salt to their food (p = 0.004). There were no significant differences between cases and controls for age, gender, ethnicity between cases and controls for systolic blood pressure. No significant difference was observed between the heart rates of cases and controls.Conclusions: Children and adolescents with syncope were more likely to have a systolic blood pressure lower than the 10th percentile, and there was no difference in the baseline heart rate. In addition, children with syncope were more likely to add salt to their food.

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“…It is a common ailment that forms 3% of emergency admissions and 1% of general hospital admissions [3]. Of all the causes of syncope, neurocardiogenic, or vagally mediated syncope (VMS) is the most common [4], with syncope secondary to cardiac causes having the worst prognosis [5]. The upright posture leads to pooling of blood in the legs and the visceral circulation, reducing cardiac preload and output, thereby activating the sympathetic and inhibiting the parasympathetic system [6-7].…”

Section: Introductionmentioning

confidence: 99%

Sleep Fainting: A Neurocardiogenic Entity

Shahab¹,

Sonawalla²,

Khan³

et al. 2018

Cureus

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Fainting is a common clinical presentation, with vagally mediated (neurocardiogenic) causes being the most common for syncope presentation to the emergency room, and for hospital admissions. Classic teaching is that upright posture is a prerequisite for vagally mediated syncope (VMS) and that syncope in the supine position has more sinister causes. We present five patients, three males and two females, with a mean age of 44.4 (range 29–67) years, who presented with VMS in the supine position (sleep fainting). Four patients also had a history of classic upright syncope. Based on their clinical features and thorough investigations, we excluded other causes of loss of consciousness and diagnosed these patients to be having VMS in the supine position (sleep fainting). We further describe the management and follow-up of these patients. Sleep fainting/syncope is a new entity and has to be recognized for appropriate management. A diagnosis can be established if there is clinical suspicion, preserved left ventricular function without evidence of coronary artery disease, no high-risk electrocardiographic evidence of pre-excitation, long or short QT syndrome, Brugada syndrome or arrhythmogenic right ventricular dysplasia, and normal neurological work-up.

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Syncope

Cited by 145 publications

References 59 publications

Cough syncope with hypertension—caused by brainstem compression?

Cough syncope with hypertension—caused by brainstem compression?

Association Between Baseline Blood Pressures, Heart Rates, and Vasovagal Syncope in Children and Adolescents

Sleep Fainting: A Neurocardiogenic Entity

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