Cardiovascular and Cerebral Responses During a Vasovagal Reaction Without Syncope.

Details

Serval ID
serval:BIB_227CD8BE2313
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Cardiovascular and Cerebral Responses During a Vasovagal Reaction Without Syncope.
Journal
Frontiers in neuroscience
Author(s)
Aebi M.R., Bourdillon N., Meziane H.B., Nicol E., Barral J., Millet G.P., Bron D.
ISSN
1662-4548 (Print)
ISSN-L
1662-453X
Publication state
Published
Issued date
2019
Peer-reviewed
Oui
Volume
13
Pages
1315
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
This clinical case report presents synchronous physiological data from an individual in whom a spontaneous vasovagal reaction occurred without syncope. The physiological data are presented for three main phases: Baseline (0-200 s), vasovagal reaction (200-600 s), and recovery period (600-1200 s). The first physiological changes occurred at around 200 s, with a decrease in blood pressure, peak in heart rate and vastus lateralis tissue oxygenation, and a drop in alpha power. The vasovagal reaction was associated with a progressive decrease in blood pressure, heart rate and cerebral oxygenation, whilst the mean middle cerebral artery blood flow velocity and blood oxygen saturation remained unchanged. Heart rate variability parameters indicated significant parasympathetic activation with a decrease in sympathetic tone and increased baroreflex sensitivity. The total blood volume and tissue oxygenation index (TOI) dropped in the brain but slightly increased in the vastus lateralis, suggesting cerebral hypoperfusion with blood volume pooling in the lower body part. Cerebral hypoperfusion during the vasovagal reaction was associated with electroencephalography (EEG) flattening (i.e., decreased power in beta and theta activity) followed by an EEG high-amplitude "slow" phase (i.e., increased power in theta activity). The subject developed signs and symptoms of pre-syncope with EEG flattening and slowing during prolonged periods of symptomatic hypotension, but did not lose consciousness.
Keywords
EEG flattening and slowing, cerebral hypoperfusion, hypotension and bradycardia, pre-syncope symptoms, vasovagal mechanism
Pubmed
Web of science
Open Access
Yes
Create date
20/01/2020 19:37
Last modification date
22/01/2020 7:26
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