In vasovagal syncope, occurrence of bradycardia/asystole in the wake of hypotension has often been considered paradoxical. The major objective of this teaching module is to critically examine the pathophysiological mechanism and significance of the hypotension-bradycardia paradox unique to this condition. We narrate here how we discussed the pathophysiology of vasovagal syncope in a large class...

BACKGROUND The effectiveness of cardiac pacing in preventing vasovagal syncope remains controversial. However, DDI pacing with rate hysteresis has been reported to prevent the recurrence of cardioinhibitory vasovagal syncope in up to 35% of affected subjects and to reduce the overall incidence of syncopal episodes in the others. Recently, DDD pacing with a new promising rate drop response funct...

BACKGROUND Vasovagal syncope is usually associated with a sudden drop of blood pressure and/or heart rate. However, occasionally the symptoms of syncope induced by orthostatic stress testing are not associated with obvious haemodynamic changes. The mechanisms of syncope in these patients are not clear. AIM To evaluate changes in cerebral blood flow velocities during orthostatic stress testing...

AIMS It can be difficult to distinguish vasovagal syncope, the most common cause of transient loss of consciousness (T-LOC), from other causes of syncope by history taking. The Calgary Syncope Symptom Score (Calgary Score) is a tool developed for this purpose. We studied its performance in a series of patients presenting with T-LOC. METHODS AND RESULTS We calculated the Calgary Score for 380 ...

Prakash, E. S., and Madanmohan. When the heart is stopped for good: hypotension-bradycardia paradox revisited. Adv Physiol Educ 29: 15–20, 2005; doi:10.1152/advan.00027.2004.—In vasovagal syncope, occurrence of bradycardia/asystole in the wake of hypotension has often been considered paradoxical. The major objective of this teaching module is to critically examine the pathophysiological mechani...

INTRODUCTION AND OBJECTIVES Little information is available on the evolution of pediatric patients with vasovagal syncope. We therefore aimed to assess the medium-term clinical outcome of children evaluated by tilt testing for syncope of unknown origin. PATIENTS AND METHOD Fifty-one children under 17 years of age who had undergone tilt testing were identified from a data base and studied pros...

While the investigation of the physiological and vasovagal syncope. The pathophysiology of the vasopathophysiological effects of orthostatic stress vagal response is thus central to an understanding induced by head-up tilt table testing in humans of the role of tilting in its diagnosis. began more than 50 years ago,1 it was not until 1986 Although central, higher cortical provocation of that th...

BACKGROUND Syncope is commonly worked up for carotid stenosis, but only rarely attributed to it. Considering paucity of such cases in literature, we report a case and discuss the pathophysiology. DESIGN/METHODS We report a patient with high-grade bilateral severe internal carotid artery (ICA) stenosis who presented with syncopal episodes in the absence of stroke, orthostatic hypotension, sign...