Reflex syncope
Brief loss of consciousness due to a neurologically induced drop in blood pressure / From Wikipedia, the free encyclopedia
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Reflex syncope is a brief loss of consciousness due to a neurologically induced drop in blood pressure and/or a decrease in heart rate.[5][6][7][8][9][10][2] Before an affected person passes out, there may be sweating, a decreased ability to see, or ringing in the ears.[1] Occasionally, the person may twitch while unconscious.[1] Complications of reflex syncope include injury due to a fall.[1]
Reflex syncope | |
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Other names | Neurally mediated syncope, neurocardiogenic syncope[1][2] |
Vagus nerve | |
Specialty | Neurology, cardiovascular |
Symptoms | Loss of consciousness before which there may be sweating, decreased ability to see, ringing in the ears[1][2] |
Complications | Injury[1] |
Duration | Brief[1] |
Types | Vasovagal, situational, carotid sinus syncope[1] |
Diagnostic method | Based on symptoms after ruling out other possible causes[3] |
Differential diagnosis | Arrhythmia, orthostatic hypotension, seizure, hypoglycemia[1] |
Treatment | Avoiding triggers, drinking sufficient fluids, exercise, cardiac pacemaker[2] |
Medication | Midodrine, fludrocortisone[4] |
Frequency | > 1 per 1,000 people per year[1] |
Reflex syncope is divided into three types: vasovagal, situational, and carotid sinus.[2] Vasovagal syncope is typically triggered by seeing blood, pain, emotional stress, or prolonged standing.[11] Situational syncope is often triggered by urination, swallowing, or coughing.[2] Carotid sinus syncope is due to pressure on the carotid sinus in the neck.[2] The underlying mechanism involves the nervous system slowing the heart rate and dilating blood vessels, resulting in low blood pressure and thus not enough blood flow to the brain.[2] Diagnosis is based on the symptoms after ruling out other possible causes.[3]
Recovery from a reflex syncope episode happens without specific treatment.[2] Prevention of episodes involves avoiding a person's triggers.[2] Drinking sufficient fluids, salt, and exercise may also be useful.[2][4] If this is insufficient for treating vasovagal syncope, medications such as midodrine or fludrocortisone may be tried.[4] Occasionally, a cardiac pacemaker may be used as treatment.[2] Reflex syncope affects at least 1 in 1,000 people per year.[1] It is the most common type of syncope, making up more than 50% of all cases.[2]