Flashcards in Vasovagal Faints Deck (6):
Vasovagal (neuro cardiogenic syncope) is due to reflex bradyc possibly with peripheral vasolidation provoked by emotion, pain, fear, or long standing (orthostatic stress), temperature, not eating/drinking. Lightheadedness or LOC.
Onset over a few seconds and often preceded by pallor, nausea, sweating, closing visual fields (pre syncope).
Requires LOC due to poor brain perfusion. And transient.
Cannot occur if lying down.
Fall, LOC for a couple of mins.
Possible brief clinic jerking but no stiffening.
Slow weak pulse
Rarely urinary incontinence.
No tongue biting
Before- pallor, light headed, tunnel vision, nausea, warm, clammy, yawning, blurred vision.
Situation syncope eg cough, effort, micturition.
Carotid sinus syncope- reflex brady due to hypersensitive baroRs.
Stokes adams attacks- transient arrhythmia.
Drop attack- sudden leg weakness.
CSF flow disruption
Slowing or temporary stop in HR=disruption brain BS.
Increased PNS output due to direct stimulation (micturition, defacation, abdo pain etc) or as reflex response to SNS stimulation (eg seeing blood, abrupt stop exercise).
Results in arterial dilation and inhibition of SAN and AVN activity.
So causes transient decrease BP.
Due to association with vagal output, they are often associated with nausea, diaphoresis, salivation.
Behavioural eg avoid triggers, compression stockings, hydration, salt intake.
Acutely- lie down with feet up, while isometric hand exercises.
Drugs eg BB, MC, alpha agonists.
Advise to look out for warning signs and tell those around them.