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Mechanism of syncope: role of ambulatory blood pressure monitoring and cardiovascular autonomic function assessment.
Eur Heart J
December 2024
Department of Cardiology, IRCCS Istituto Auxologico Italiano, Faint and Fall Research Centre, S. Luca Hospital, Piazzale Brescia 20, Milano 20149, Italy.
Background And Aims: Identifying the haemodynamic mechanism of autonomic syncope is the essential pre-requisite for effective and personalized therapy aimed at preventing recurrences. The present study assessed the diagnostic efficacy of a two-step assessment.
Methods: Multicentre prospective, cross-sectional, observational study.
A Case of Severe Advanced Diabetic Cardiac Autonomic Neuropathy: Severe Orthostatic Hypotension Complicated With Episodes of Nocturnal Supine Hypertensive Emergency Episodes.
Cureus
December 2024
Internal Medicine, Meharry Medical College, Nashville, USA.
Diabetic cardiac autonomic neuropathy (CAN) is caused by damage to the autonomic nerve fibers that innervate the heart and blood vessels, leading to abnormalities in heart rate control and vascular dynamics. CAN encompasses symptoms such as exercise intolerance, orthostatic hypotension, cardiac denervation syndrome, and nocturnal hypertension. Neurogenic orthostatic hypotension (nOH), resulting from severe diabetic CAN, can cause symptomatic orthostatic hypotension.
View Article and Find Full Text PDFLeadless Pacemaker Implantation in Challenging Scenarios: A Case Report Series of Patients with Mechanical Tricuspid Valves.
Indian Pacing Electrophysiol J
December 2024
Intermountain Heart Institute - Utah Valley Hospital, Salt Lake City, Utah, USA.
Introduction: The advancement of medical technology has introduced leadless pacemakers (LPMs) as a significant innovation in cardiac pacing, offering potential advantages over traditional ventricular transvenous pacemakers. This report explores the application of LPMs in two patients with complex valvular histories, particularly those with mechanical tricuspid valves.
Case Reports: The first case involves a 60-year-old male with a history of rheumatic heart disease and triple valve replacement who developed a high-grade AV block.
Haemodynamic effects of fludrocortisone and midodrine in patients with symptoms due to hypotension.
Clin Auton Res
December 2024
Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Aim: The study aimed to assess the haemodynamic effects of fludrocortisone and midodrine, alone or combined, in patients with recurrent syncope and/or symptoms due to hypotension and ≥ 1 daytime systolic blood pressure (SBP) drop < 90 mmHg or ≥ 2 daytime SBP drops < 100 mmHg recorded by 24-h ambulatory blood pressure monitoring (ABPM1).
Method: A total of 53 patients (mean age, 40.9 ± 18.
Vasovagal Syncope: A Review of Current and Emerging Therapies for a Common Cardiology Condition.
J Tehran Heart Cent
January 2024
Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Vasovagal syncope (VVS), characterized by transient loss of consciousness, is among the most prevalent reasons for emergency visits worldwide. Although benign in nature, VVS can be accompanied by traumatic injury, leading to morbidity and decreased quality of life, especially in those with VVS recurrence. The management includes non-pharmacologic and pharmacologic therapies (if resistant), patient education and reassurance, salt and fluid intake increase, and physical counter-pressure maneuvers.
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