Neurocardiogenic Syncope

Neurocardiogenic Syncope

Miniaci Performing Arts Center

This research was conducted by reviewing studies conducted on neurocardiogenic syncope, primarily in the United States and India, in an attempt to better understand the causes of the condition.

Neurocardiogenic syncope, also referred to as vasovagal syncope vasodepressive syncope, neurally mediated syncope, and neurally mediated hypotension, is the most commonly diagnosed form of syncope, accounting for 3-5% of emergency room visits and from 1-6% of hospital admittances yearly.

The condition is incompletely understood and quite often difficult to diagnose: the most common diagnostic tool, the Head-Up Tilt Table Test, results in false positives 2-6% of the time through passive testing, and 13-26% of the time during active testing where intravenous isoprotenerol or adenosine, or sublingual nitroglycerine are used to stimulate responses during the test.

Prolonged periods of standing, a sudden rise to the upright position, or a number of triggers that include coughing and swallowing can stimulate an episode, which generally involves dizziness, lightheadedness, and a sudden loss of both consciousness and postural tone. These symptoms are sometimes preceded by nausea, headache, blurred vision, or a radical change in heart rate.

While most common in adolescents, neurocardiogenic syncope affects those ranging from small children to the elderly. Research does not agree on the actual cause of the condition, although depleted blood volume, blood pooling in the lower extremities during sudden or prolonged standing, or inhibition of the sympathetic nervous system have all been designated as contributing factors.

Treatment varies; pharmaceuticals which have been beneficial in some patients include Beta-blockers, serotonin uptake inhibitors and midorine. Other treatments include the new practice of tilt training, although the most effective and widely-used treatment is simple volume repletion.