• 제목/요약/키워드: Vasovagal syncope

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혈관미주신경실신의 새로운 기전 -삼차신경-심장반사- (New Mechanism of Vasovagal Syncope -Trigeminocardiac Reflex-)

  • 윤지영;김철홍
    • 대한치과마취과학회지
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    • 제12권3호
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    • pp.151-155
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    • 2012
  • A vasovagal reaction is defined as the 'development of hypotension and bradycardia associated with the typical clinical manifestations of pallor, sweating and weakness'. The most profound degree of vasovagal reaction results in fainting or syncope. Incidence of vasovagal reactions in the local anesthetic department of a dental hospital is around 2%. The pathophysiology of the hypotension/bradycardia reflex responsible for vasovagal syncope is not completely understood. Central as well as peripheral mechanisms have been implicated in its pathogenesis: however their relative contribution is not fully elucidated. Recently, trigeminocardiac reflex, previously known as oculocardiac reflex, may serve as syncope. The management of vasovagal syncope is evolving. Non-pharmacological treatment options are a fundamental first step of all treatment pathways. In this article, we would like to review new mechanism of vasovagal syncope and hope to be of help to manage the syncopal patients.

훈침의 미주신경 실신 측면으로 이해와 적절한 예방과 조치 (Understanding Acupuncture Needle-Associated Vasovagal Syncope for the Purpose of Preventing and Managing Adverse Events)

  • 이서영;류연희;이인선;채윤병
    • 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.

상하악 치조골 결손 환자에서 전신 마취 전 발생한 혈관미주신경성 실신 (Vasovagal Syncope before General Anesthesia in a Patient with Alveolar Bone Deficiency on Maxilla and Mandible)

  • 윤상용;윤지영;김철홍
    • 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.

『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 오령산(五笭散) 투여 후 호전된 미주신경성 실신 증례 보고 1례 (A Case Report of Vasovagal Syncope Treated by Oryeong-san Based on Shanghanlun Provisions)

  • 두인선;이성준
    • 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.

미주신경성 실신 증례보고 1례 (A Clinical Case Study of Vasovagal Syncope)

  • 장재원;노지애;김현중;홍정수;배영춘;김동진
    • 대한한방내과학회지
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    • 제38권2호
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    • pp.240-245
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    • 2017
  • Objectives: The purpose of this clinical case report is to describe the efficacy of Korean medicine in the treatment of vasovagal syncope. Methods: The patient was treated with acupuncture, pharmacopuncture, and herbal medicine. The symptoms (headache, palpitation, sweating, flushing, weakness, coldness) of the patient were observed. Results: After the treatment, the patient's symptoms improved, but more treatments were required. Conclusion: This study can add to understanding of the effect of Korean medicine on vasovagal syncope.

기립경사도 검사에 의한 실시환자의 심박변동신호 특성에 관한 연구 (A study on the characteristics of heart rate variability of patients with vasovagal syncope by tilt-table test)

  • 이정환;박찬석;이병채;김준수;이명호
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 1998년도 하계종합학술대회논문집
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    • pp.561-564
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    • 1998
  • This paper evaluated autonomic nervous system function in 23 patients with syncope and a positive tilt test result, 21 with a negative test result, and 19 healthy controls. Indexes of heart rate variability were measured during supine resting, immediately afte rtilt-up, standing rsting, immediately before syncope and immediately after tiltdown. There were no significant differences among the groups in any of the indexes of heart rate varability over the 24-hour holter recordings. In patients with a positive tilt result, tilting gaused a decrease in low-frequency (LF) immediately before syncope and incsrease in high-frequency (HF) bands immediately before. In patients with a negative tilt result, tilting caused a decrease in low-frequency (LF) immediately before syncope and decrease in high-frequency (HF) bands immediately before, different from positive tilt results. Our findings showed that patients with vasovagal syncope have no chronic differences from normal subjects in autonomic nervous system activity, but that these patients respond differently to the orthostatic stimulus.

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Vasovagal syncope with mild versus moderate autonomic dysfunction: a 13-year single-center experience

  • Lee, Han Eoul;Lee, Dong Won
    • 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.

혈관미주 신경성 실신 소아에서 기립경사 검사 동안에 뇌혈류 변화 (Change of Cerebral Blood Flow during Tilt Tests in Children with Vasovagal Syncope)

  • 김수정;염혜원;홍영미;유정현;이숙희;김종희
    • 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.

CDM 방법에 의한 실신 환자의 심박동수 변화율의 PSD 특성에 관한 연구 (PSD on the Characteristic of Heart Rate Variability of patients with Vasovagal Syncope by Complex Demodulation Method)

  • 최규섭;이준영;김동철;윤성원;이명호
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2000년도 추계학술대회 논문집 학회본부 D
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    • pp.854-856
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    • 2000
  • In this paper, complex demodulation method to access the dynamic autonomic nervous system characteristic of patients with syncope is proposed. Assessment of heart rate variability using conventional power spectral analysis such as FFT or AR-modeling could not capture a split change occurrence. However, in this paper, these changes are seen and by using Complex Demodulation Method(CDM) autonomic nervous system function assessments of patients with vasovagal syncope were verified and suggested.

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CDM 방법에 의한 실신 환자의 심박동수 변화율 특성에 관한 연구 (A Study on the Characteristic of Heart Rate Variability of patients with Vasovagal Syncope by Complex Demodulation Method)

  • 이동준;이정환;이준영;김한수;이명호
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 1999년도 추계학술대회 논문집 학회본부 B
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    • pp.624-1-624-3
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    • 1999
  • In this paper, complex demodulation method to access the dynamic autonomic nervous system characteristic of patients with syncope is proposed. Assessment of heart rate variability using conventional power spectral analysis such as FFT or AR-modeling could not capture a split change occurrence. However, in this paper, these changes are seen and by using Complex Demodulation Method(CDM) autonomic nervous system function assessments of patients with vasovagal syncope were verified and suggested.

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