Vasovagal Syncope

Objectives (1) ,[object Object],[object Object],[object Object],[object Object]

Objectives (2) ,[object Object],[object Object],[object Object],[object Object]

Many Causes of Syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Homeostasis Mr. Sympathetic vs. Mr. Parasympathetic  BP  HR Vasoconstriction  BP  HR Vasodilitation

Vasovagal Presentation ,[object Object],[object Object],[object Object],[object Object]

Normal Autonomic Nervous System Regulation of Cardiovascular Hemodynamic Responses ,[object Object],[object Object],[object Object]

Abnormal Autonomic Nervous System Regulation of Cardiovascular Hemodynamic Responses ,[object Object],[object Object],[object Object]

Vasovagal Syncope ,[object Object],[object Object],[object Object]

Two Common Precipitating Situations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Both result in vasodilitation and possible bradycardia

Facts ,[object Object],[object Object],[object Object],[object Object],[object Object]

Precipitating and Aggravating Factors for Vasovagal Syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patients At Higher Risk for Vasovagal Syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

U of Washington Study (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],Pavlin, et. al. (1993)

U of Washington Study (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pavlin, et. al. (1993)

U of Washington Study (3) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pavlin, et. al. (1993)

Faints Associated With Removal of Stress ,[object Object],[object Object],[object Object],[object Object],Graham, et al. (1961)

This Faint Mechanism ,[object Object],[object Object],Graham, et al. (1961)

Cardiac Arrest Associated With Venipuncture ,[object Object],[object Object],[object Object],[object Object],Tiezes (1976)

Vasovagal Reactions Associated With Sheath Removal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vasovagal vs. Orthostasis ,[object Object]

Orthostatic Hypotension (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Orthostatic Hypotension (2) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Historical Observation ,[object Object],[object Object],[object Object]

Vasovagal Care First, assess your patient Decreased BP Decreased BP Decreased HR Decreased HR Lie down Observe O 2 ± Trendelenberg ± NS Conscious Loss of Consciousness Lie down Trendelenberg O 2 NS Lie down Trendelenberg O 2 NS / Atropine Lie down Trendelenberg O 2 Atropine

FYI - Tilt Table Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vasomotor Reaction ,[object Object],[object Object],[object Object]

Review ,[object Object],[object Object],[object Object]

Review Question ,[object Object],[object Object],[object Object]

Situation 1 ,[object Object],[object Object],[object Object],[object Object]

Situation 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Objectives (2) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Vasovagal Syncope

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Vasovagal Syncope