• 대한치과마취과학회지
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• 제11권2호
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• pp.159-163
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• 2011

Vasovagal syncope accounts for the majority of adverse events that occur in dental offices and is normally related to emotional or somatic factors. The factors trigger intense parasympathetic state, leading to bradycardia and hypotension. We experienced a case of vasovagal syncope just before general anesthesia. A 49-year-old woman with alveolar bone deficiency on maxilla and mandible was planned to undergo an alveolar bone graft with mandibular body under general anesthesia. She didn't have any histories of disease, medication or syncope. Though she showed a little anxiety from admission, she had no pre-operative medication. After she was guided to the operating room, she had signs and symptoms of vasovagal syncope without any prodromes. The patient was resuscitated soon only by the conservative treatment and was operated under general anesthesia.

• 대한한방내과학회지
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• 제26권4호
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• pp.806-819
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• 2005

Objective : The purpose of this study is to investigate clinical characteristics and remedial value oriental medical therapy for sufferers of severe headache. Methods : On the authority of DongEuiBoCam, patients were classified into three groups: migraine, qi-syncope headache and phlegm-headache. All patients wert treated with acupuncture therapy and herb medicines. After that inquiry was made into the extent of improvement of headache. Results : 1. In accordance with the statistics, 56 cases(50.5%) had phlegm-syncope headache, 28 cases(25.2%) had qi-syncope headache and 27 cases(24.3%) had migraine. 2. The ratio between males and females was about 1:4. Most patients were in their forties. 3. 12 cases(31.6%) with migraine had pain only on the right side of the head, 20 cases(26.3%) with phlegm-syncope and 17 cases(45.6%) with qi-syncope headache suffered from the frontal lobe headache. 4. 8 cases(29.6%) with migraine had been suffering for a week or less, 12 cases(21.4%) with phlegm-syncope headache had been suffering for over six months and under one year and 6 cases(21.4%) with qi-syncupe headache had suffered over one year and under five. 5. Overwork and stress was deemed the main cause of migraine. Phlegm-syncope headache was also attributed to stress and tense situations. Qi-syncope headache was believed to be variously caused by traffic accident, noise, blood pressure and other reasons. 6. 46 cases(30%) felt dull headache and 32 cases(20.9%) felt dizzy. The common associated symptoms of migraine and qi-syncope headache included back, neck and shoulder pain and other pains. Dizziness was an especially prevalent symptom of phlegm-syncope headache. 7. After the oriental medical therapy, 12 cases(10.8%) almost entirely recovered, 50 cases(45%) were in about half as much pain, 45 cases(40.5%) improved little and 4 cases(3.6%) felt no improvement. Conclusions : The results support a role for oriental medical therapy in treatment of headache.

• 의학교육논단
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• 제20권2호
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• pp.112-117
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• 2018

Attending the operation room is an essential part of surgical clerkships. Syncope or presyncopal attacks in the operation room may negatively affect students' learning and career development. This study set out to identify the prevalence of syncope and presyncopal attacks in the operation room during medical students' surgical clerkships. Data from 420 medical students (303 men and 117 women) in their 3rd year of clerkship were collected between 2014 and 2017. An anonymous questionnaire was distributed to assess the prevalence and degree of syncope and presyncopal symptoms. A total of 27% of the respondents had experienced syncope or presyncopal symptoms, 49.6% of the female students and 18.8% of the male students (p<0.001). Fifty students (43.5%) had been attending as observers at the time of the syncopal attack, while 65 students (56.5%) had been participating as assistants. Thirty-four students (29.6%) had recently eaten at the time of the syncopal attack, while 81 students (70.4%) had not recently eaten. Prodromal symptoms included the urge to sit down (21.2%), sweating (19.3%), nausea (16.9%), a feeling of warmth (13.3%), darkened vision (12.6%), yawning (11.7%), palpitation (11.0%), ear fullness (10.2%), black spots in one's vision (7.6%), and hyperventilation (7.1%). This study showed the prevalence of syncope and presyncopal symptoms in the operation room during surgical clerkships. For students' safety and effective clerkship learning, thorough proactive education on syncopal attacks is required.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.512-517
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• 2008

목 적 : 실신은 소아와 청소년기에 비교적 흔히 발생하는 질환이다. 이중에서도 신경-심인성 실신은 실신의 원인 중 가장 많은 빈도를 보이며, 경련 증상과 혼동되기 쉬운 질환이다. 이에 저자들은 실신을 주소로 내원한 15세 이하 환자 중, 신경-심인성 실신 환자들과 간질을 포함한 신경성 질환 환자들을 비교하여, 신경-심인성 실신의 임상적 특징을 알아보고자 하였다. 방 법 : 2005년 3월부터 2007년 2월까지 2년간 청주성모병원과 충북대학교 병원 소아과에 실신을 주소로 내원한 69명의 환자를 대상으로 하였다. 환자들을 실신의 원인에 따라 분류한 후, 신경-심인성 실신 군과 신경학적 질환 군 사이에 내원당시 나이, 성별, 실신의 장소, 계절 및 시간, 경련 등의 동반증상, 실신 유발인자, 실신 전 증상, 실신의 지속시간, 과거 실신의 횟수, 출생력, 동반질환, 과거병력, 가족력, 신경학적 검사 및 이학적 검사, 혈액검사, 심전도검사, 뇌파검사, 기립경 검사, 뇌 CT 혹은 MRI 검사결과 등을 비교하였다. 신경-심인성 실신 군 환자들은 다시 기립성 실신 군, 상황에 따른 실신 군, 기타 원인에 의한 실신 군으로 나누고, 세 군 간에 기립경 검사 결과를 비교하였다. 결 과 : 신경-심인성 실신 군은 전체 69명의 실신 환자 중 53명(76.8%) 이었고, 신경학적 질환 군이 11명(15.9%) 이었다. 신경-심인성 실신 군과 신경학적 질환 군 간에 실신 전 증상과 뇌파를 제외한 변수들에서는 통계적으로 유의한 차이가 없었다. 실신 전 증상은 신경-심인성 실신 군에서 49명 중 23명(46.9%), 신경학적 질환 군에서 11명 중 1명(9.1%)으로, 신경-심인성 실신 군에서 실신 전 증상의 빈도가 유의하게 높았다(P= 0.038). 뇌파검사의 이상은 신경학적 질환 군에서 10명 중 9명(90%), 신경-심인성 실신 군에서는 52명중 3명(5.8%)에서 나타나, 신경학적 질환 군에서 뇌파의 이상 빈도가 유의하게 많았다(P<0.01). 신경-심인성 실신 환자 53명 중 34명에서 기립경 검사를 시행하였으며, 양성결과를 보인 환자는 8명(23.5%) 이었다. 상황에 따른 실신 환자 군, 기립성 실신 환자 군, 기타 원인 군 간에 기립경 검사 결과의 차이는 없었다. 결 론 : 실신을 주소로 내원한 환자에서 신경-심인성 실신을 정확히 진단하기 위해서는, 실신 전 증상 등을 포함한 자세한 병력청취가 중요할 것으로 생각되며, 실신의 원인으로 경련 등의 신경학적 질환이 의심될 때는 뇌파검사가 필요할 것으로 사료된다.

• The Korean Journal of Pain
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• 제23권3호
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• pp.215-218
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• 2010

Glossopharyneal neuralgia (GPN) is generally considered to be a pain disease. However, it can be also be a life-threatening cardiac cause of syncope. Neuralgia in the throat and neck can trigger severe bradycardia up to the point of asystole, which can progress to cardiac syncope with or without seizures. A 65 year-old male patient diagnosed with glossopharyngeal neuralgia complained of severe paroxysmal pain in his right chin and ear followed by bradycardia, aystole and syncope. We report a case successfully treated with a permanent pacemaker and carbamazepine in a patient with GPN who had syncopal attacks preceded by paroxysms of pain.

• 한국응급구조학회지
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• 제25권1호
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• pp.235-241
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• 2021

Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

• Korean Journal of Acupuncture
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• 제40권4호
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• pp.206-211
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• 2023

Objectives : Needle sickness is one of the adverse events of acupuncture, although substantial adverse effects during a routine acupuncture treatment seem to be highly unusual. In this work, we propose that an acupuncture-related vasovagal response resembles needle sickness during acupuncture therapy. Methods : In this article, we discussed the general characteristics of vasovagal syncope and went into more detail on vasovagal syncope in people who have a fear of blood injection and injury. We also offer a recommendation for the prevention and management of vasovagal syncope brought on by acupuncture. Results : The vasovagal reaction related to acupuncture is closely associated with needle sickness. The prevention can be done using PEACHES (position, experience, anxiety, constitution, hydration, environment, symptom recognition) principles. The management should be conducted using the RIPCORD (recognize, initiate, position, communicate, order treatments, reassess, document) techniques. Conclusions : It is important to comprehend the characteristics of needle sickness as a vasovagal reaction related to acupuncture. According to the recommendation, practitioners should effectively prevent and manage needle sickness.

• 대한상한금궤의학회지
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• 제12권1호
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• pp.81-89
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• 2020

Objective: This case report presents the effect of Oryeong-san on vasovagal syncope. The patient was diagnosed with Grater Yang disease based on Shanghanlun provisions. Methods: According to the disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS), we diagnosed the patient as presenting Greater Yang disease. The patient was treated with Oryeong-san for 45 days. The change in symptoms was estimated based on VAS. Results: After treatment, the patient's VAS score from 10 to 0 and he was completely cured. Conclusions: This case study shows the effectiveness of using Oryeong-san on vasovagal syncope according to DPIDS.

• Clinical and Experimental Pediatrics
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• 제65권1호
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• pp.47-52
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• 2022

Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study aimed to differentiate patients with VVS by autonomic dysfunction severity using the composite autonomic severity score (CASS) and compare the clinical manifestations and prognosis between patient subgroups. Methods: We retrospectively reviewed the medical records of 66 VVS patients divided into 3 groups by CASS. To compare the differences between these groups, we analyzed VVS type, triggers, prodromal symptoms, management of syncope, and prognosis between patients with mild versus moderate autonomic dysfunction. Results: Of our 66 patients with VVS, 41 had mild autonomic dysfunction (62.1%) and 25 had moderate autonomic dysfunction (37.9%). We found no significant intergroup differences in age, sex, inducible factor (P=0.172), prodromal symptoms, laboratory findings, head-up tilt test, type of syncope, or prognosis (P=0.154). Conclusion: We found no evidence that autonomic dysfunction degree is affected by VVS characteristics, test findings, parameters, or prognosis; therefore, no further evaluations are needed to classify autonomic dysfunction severity.

• Clinical and Experimental Pediatrics
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• 제46권10호
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• pp.983-988
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• 2003

목 적 : 실신은 소아에서 가장 흔한 증상이지만 기전은 잘 알려져 있지 않다. 증가된 미주신경의 활동과 감소된 교감신경의 자극이 저혈압, 서맥을 일으키고 마침내는 의식 소실을 초래한다. 이 연구의 목적은 혈관미주 신경성 실신으로 진단된 소아에서 기립경사 검사를 하는 동안 뇌 도플러 초음파를 실시하여 실신 전후의 뇌혈류 속도와 혈압, 심박동수 변화를 측정하고자 하였다. 방 법 : 실신의 과거력을 갖고 있는 64명의 소아를 대상으로 혈압을 10분간 안정 후와 15분 동안 기립 후에 측정하였고, 기립 경사 검사는 $80^{\circ}$에서 45분간 시행하였다. $80^{\circ}$ 각도의 경사 테이블에서 소아를 5분 간격으로 45분 동안 혈압, 심박동수, 산소 포화도를 측정하였다. 기립경사 검사를 하는 동안 실신이나 실신 전 증상이 나타난 소아에서는 검사를 중단하였다. 12-유도 심전도, 뇌파 검사, 심장 초음파를 시행하였다. 기립경사 검사에서 양성으로 나온 10명의 소아에서 Acouson 128XP/10 model 초음파 기기를 이용하여 중 대뇌동맥 혈류 속도, pulsatility 지수, time velocity integral, 혈압, 심박동수, 산소포화도 등을 측정하였다. 결 과 : 기립경사 검사에서 31.3%(20/64)의 양성률을 보였다. 검사 동안에 혈압과 맥박은 감소되지 않았고 뇌혈류 속도와 integral은 유의하게 감소되었다. 결 론: 뇌혈류 속도는 혈압이나 심박동수가 감소하기 전에 미리 감소하므로 실신 전 증상을 미리 예측할 수 있다. 뇌혈류의 자율 조절의 장애가 혈관미주 신경성 실신의 병인론에 중요한 역할을 하리라 생각된다.