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Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
Episodes of vasovagal syncope are typically recurrent and usually occur when the predisposed person is exposed to a specific trigger. Before losing consciousness, the individual frequently experiences early signs or symptoms such as lightheadedness, nausea, the feeling of being extremely hot or cold (accompanied by sweating), ringing in the ears, an uncomfortable feeling in the heart, fuzzy ...
Rates are highest between the ages of 10–30 years old. This is likely because of the high rates of vasovagal syncope in the young adult population. Older adults are more likely to have orthostatic or cardiac syncope. Syncope affects about three to six out of every thousand people each year. [1] It is more common in older people and females. [7]
The drop in blood pressure may be sudden (vasovagal orthostatic hypotension), within 3 minutes (classic orthostatic hypotension) or gradual (delayed orthostatic hypotension). [4] It is defined as a fall in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg after 3 minutes of standing.
Dysautonomia, autonomic failure, or autonomic dysfunction is a condition in which the autonomic nervous system (ANS) does not work properly. This condition may affect the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels.
A frequent type of syncope, termed vasovagal syncope is originated by intense cardioinhibition, mediated by a sudden vagal reflex, that causes transitory cardiac arrest by asystole and/or transient total atrioventricular block. [1] [2] It is known as “Vaso-vagal Syncope”, “Neurocardiogenic Syncope” or “Neurally-mediated Reflex Syncope ...
Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing. [1] POTS is a disorder of the autonomic nervous system that can lead to a variety of symptoms, [10] including lightheadedness, brain fog, blurred vision, weakness, fatigue, headaches, heart palpitations, exercise intolerance, nausea ...
However, if the Bezold–Jarisch reflex is activated due to the reduced ventricular volume this may trigger paradoxical bradycardia and arterial hypotension resulting in syncope. The importance of this mechanism is unclear since vaso-vagal syncope can be observed in cardiac transplant patients who are presumed to lack cardiac innervation. [6]