Vasovagal syncope is the commonest cause for syncope in our population.It is also referred to as simple syncope .The mechanism is thought to be an abnormal overshoot response by the vagus in response to a sudden surge of adrenegic activity usually occurring in erect posture following , often an emotional or physically stress full situation .The receptors for this reflex pathway is thought to be located left ventricular myocardium .
There are two components for the VV syncope
- Cardio inhibitory
- Vaso depressive.
The quantum of contribution by each component in a given episode of syncope varies. Pure vasodepressive or cardioinhibitory forms can occur .
Diagnostic issue
Before labeling a patient as simple vasovagal syncope all potentially serious , cardiac causes must be ruled out. this may require a fairly extensive investigation in some
Read the related blog : Why syncope is rarely fatal ?
https://drsvenkatesan.wordpress.com/2008/09/30/why-syncope-is-rarely-fatal/
Management of vasovagal syncope.
- Reassurance is the mainstay . By this we mean , V V syncope may never kill . . .
- Prevention – Involves identifying syncope prone situations & taking precaution
- Emotional support
- Pharmacological approach
Some will benefit from beta blockers, fludro cortisone(Increase the intra and extra cellular fluid space )
Since these are simple , cheap treatments , we worked over time to innovate & find some interventional solutions for this life threatening condition !!!. Thus , the indication for cardiac pacing for vasovagal syncope came into vogue .
DDDR pacemaker was implanted worldwide for thousands of patients with vasovagal syncope .
It took many years for our intellectual brains to realise , there are two limbs to vasovagal syncope Pacemakers , at no stretch of imagination is expected to counter vasodepresssive component of the syncope.
And then this article came !
Water , (Simple H2O ! ) administered at right time in right quantity can prevent most episodes of vaso vagal syncope . When a tumbler of water can be substituted for a 10000 $ misadventure (DDD pacing) , and further we have hundreds of similar examples in modern day health care , no surprise why our health care system is sinking along with our economy !
Epilogue :
In this 21st century medical “AVATAR ” , we need to realise in a strong manner, low cost medicines often provide high quality cure ” while ,” many of the high cost therapies may end up in low quality treatment !
It took 50 years of intense research of medical comunity to realise , a good diet , physical activity and quitting smoking has the greatest way to control and reverse the cardiovascular epidemic . Please , note all of them come at free of cost .
Dr.S.Venkatesan MD 