Talk:Reflex syncope

message: The causes listed in this section, according to the citation, are related to the more general "vasomotor syncope" rather than "vasovagal syncope" as indicated. For example, P.O.T.S., orthostatic hypotension, low blood sugar, etc., are separate causes of syncope (fainting) in general. I don't think any of those can be said to be causes of *vasovagal* syncope, which is itself a separate cause of syncope. Comments? IamNotU (talk) 12:38, 13 August 2013 (UTC)
replies: text: I agree. Also, there's no specific mention of nor link with Hypervagaltonia and Sinus node dysfunction / Sick sinus syndrome. Thank you, Wordreader (talk) 14:19, 25 July 2014 (UTC)
thread_title:  Causes incorrect 

message: How would ginger ale help?  I haven't done any research outside of reading that line, but as far as I know, modern day ginger ale is no different from any other soda in terms of ingredients.
: That entire line seems somewhat spurious, regardless, as the end of the sentence directly before it clearly mentions increasing fluid and salt intake. Plus there's a comma splice!  Yuck.  I'll clean it up a bit.  - Zowch 09:02, 28 May 2006 (UTC)
replies: text: When I was on active treatment, I was ordered to drink .5 gallons of Gatorade (or any other electrolyte heavy fluid a day). This was for the sodium and the electrolytes. I was also taking 1gm of sodium by tablet a day (in addition to eating a salt heavy diet) and Flourinef (I do not remember the dosage... I was probably 100 lbs at the time of the treatment). I have never heard about ginger ale being a home-remedy. --SirGrok 19:26, 30 May 2007 (UTC)
thread_title:  Ginger Ale? 

message: "Vasovagal syncope (also vasodepressor syncope ...[truncated]... It is important to realize that vasovagal syncope and vasodepressor syncope are NOT the same." (Quoted from the version on 8/10/2006.)
This is a contradiction. Either vasovagal syncope is also known as vasodepressor syncope or they are not the same. Someone with medical expertise, please clairfy. Jxyama 17:37, 10 August 2006 (UTC)
thread_title:  Contradiction?? 

message: I removed from the article the sentance, "It may also be associated with certain psychiactric disorders."  There's no citation for this.  Is this true?  And if it is, what psychiatric disorders are associated?  --Brokenchairs (talk) 14:56, 19 January 2008 (UTC)
thread_title:  Prognosis 

message: Instead of saying 'sayone faints', would 'someone Vasovagal syncopes' make sense just to be complicated to people? 86.135.42.213 (talk) 14:48, 20 April 2008 (UTC)
thread_title:  Being complicated 

message: I have always been a sufferer of vasovagal syncope, triggered by medical procedures.  Most often, it is receiving injections.. I'll be fine during the injection, but within 5 minutes I lose blood pressure and start feeling very queasy, to the point of fainting.  Sometimes, it takes merely thinking about medical procedures to trigger the effect.  Once, I was at a friend's apartment and he was flipping through TV channels, and came across a liposuction procedure on Discovery.. Very harsh and painful looking procedure, it makes me feel uncomfortable even thinking about it as I type this.. But I had to ask him to change the channel because I felt like I was going to faint.
..My point is, this is my personal experience based anecdotal citation for adding the "viewing/experiencing medical procedures" to the Triggers section.
Weasel5i2 (talk) 08:53, 5 May 2008 (UTC)
replies: text: I suffer from vasovagal syncope during injections as well. Last night, I suffered one after watching a very realistic dramatization of phlebectomy. I have no problem watching extremely gory and violent films, but in this case, because the situation was made to be as realistic and matter-of-fact as possible, it brought back memories of being hospitalized during the influenza outbreak of 1962 (at the age of 2), and down I went. 
I don't see a reference to alcohol as either a trigger or at least a contributor. I am an occasional sufferer and when I discussed it with my doctor he immediately asked about alcohol consumption, which was a common factor in my case, and said that it was a "usual" factor (his term) in a vasovagal episode. If anyone can cite this I suggest it would be a useful addition. Delverie (talk) 18:10, 26 July 2009 (UTC)
thread_title:  Triggers 

message: Are beta blockers still used for Postural orthostatic tachycardia syndrome, which also involves vasovagal syncope?  WhatamIdoing (talk) 17:01, 28 July 2008 (UTC)
thread_title:  Beta blockers 

message: The British Medical Journal has a good overview (free) on this topic here.  It might be useful for cleaning up some of this article and/or sourcing some of the parts that already exist and are correct.  WhatamIdoing (talk) 04:47, 3 February 2009 (UTC)
thread_title:  New source 

message: I could not figure out how to fix:
References
   1. ^ vasovagal attack      
      at Dorland's Medical Dictionary will not affect my baby girl kaitlin.
I searched for "kaitlin" in the edit view of the page, and nothing came up. I'm sorry I can't do more, but I'm chronically ill so most days I can only do quick fixes, meaning sometimes I can only point out the problem and hope someone else will fix it. Thanks!  —Preceding unsigned comment added by Geekdiva (talk • contribs) 05:01, 29 March 2010 (UTC)
replies: text: no "will not affect my baby girl kaitlin" nonsense in currentversion - suggest refresh your page view. David Ruben  Talk  20:40, 4 April 2010 (UTC)
thread_title:  Need an expert in Wiki syntax to fix References problem 

message: Vagus reflex currently covers same topic and is a mere stub to this article, listing just a limited selection of causes. David Ruben  Talk  20:37, 4 April 2010 (UTC)
thread_title: Merge vagus reflex

message: The article needs detailed and extensive information about immediate and lingering after-effects.  What is the mechanism of recovery from vvr?  What makes it faster or slower?  How long can there be subtle after-effects (such as lower than normal heartrate): hours? days? weeks? -71.174.188.137 (talk) 03:38, 11 May 2010 (UTC)
thread_title:  aftermath/resolution 

message: I think it is worth mentioning that syncope can be accompanied by seizure like behaviors (convulsions and eyes rolling back). This happened to my 9 yr old daughter yesterday and it lasted less than 10 seconds.  Of course this was very frightening, but the E.R. doctor said that is was only syncope, (he said "fainting" or "passing out, probably caused the severe pain from her bumping her elbow/funny bone just before it happened) and not a seizure because:
1. She regained consciousness almost immediately after falling (becoming prone allowed her blood pressure to return to normal)
2. She was not groggy or "out of it" after she regained consciousness (it if were an actual seizure her brain would have needed 30-60 minutes to "reset" but she was her usual self immediately)
3. Her EKG was normal  __________    source: http://www.medlink.com/medlinkcontent.asp Hbmh (talk) 15:07, 28 March 2012 (UTC)
thread_title:  Signs and Symptoms 

message: Hey, I'm just curious, since I didn't see anything definitive in the article, but is this disorder a heritable condition?  — Preceding unsigned comment added by 70.247.173.255 (talk) 21:30, 11 May 2012 (UTC)
replies: text: It is not really a disorder, just a predisposition or hypersensitivity to some trigger. The aetiology of the hypersensitivity is very diverse, certainly you will find cases of inheritance. Richiez (talk) 22:21, 12 May 2012 (UTC)

text: Yes, http://www.neurology.org/content/79/6/561.abstract, fainting of this form was more common among identical twins than in fraternal pairs.  — Preceding unsigned comment added by PaigePhault (talk • contribs) 13:32, 13 November 2012 (UTC)
thread_title:  Genetic? 

message: The page as written is exclusively from a medical perspective and therefore not very useful as an encyclopedia page.  I would like to see a more balanced perspective incorporating for example material from
http://www.ncbi.nlm.nih.gov/pubmed/18592129
that might explain the origin of this malady - if it is a malady.  — Preceding unsigned comment added by PaigePhault (talk • contribs) 13:30, 13 November 2012 (UTC)
thread_title:  Evolutionary origin and potential benefits 

message: The following line in the opening paragraph,
"Vasovagal syncope affects young adults more commonly."
should be changed to
"Vasovagal syncope more commonly affects young adults."
Wisdomthatiswoe (talk) 15:37, 18 June 2013 (UTC)
replies: text:  Will do, thank you! Wisdomthatiswoe (talk) 15:08, 8 July 2013 (UTC)
thread_title:  Small change 

message: This information came from a neighbor who is an occuptional therapist and I have searched the internet to see if anyone else mentions it.  Have not found it.  The instructionw were not to
shuffel wehen walking. Step down hard to send send signals to the brain.  The message reaches the brain at abour 200 mph.  This works for me and another friend I explained it to. If 
you feel a bit light headed when rising from a chair then this is a good option to try.
It really works for me.   Jim R.    If you want let me know your thoughts    jiranz@cmhregional.com  — Preceding unsigned comment added by 216.68.205.2 (talk) 15:04, 27 November 2013 (UTC)
replies: text: I would use caution with this suggestion. If you are standing and feel like you are about to pass out, walking may not be a wise choice. Immediately lying down might be a far better one. Thank you, Wordreader (talk) 14:40, 25 July 2014 (UTC)

text: By the way, in your example of arising quickly from a chair can cause orthostatic hypotension, a separate situation from vasovagal response: http://www.webmd.com/heart-disease/tc/fainting-topic-overview  Thank you, Wordreader (talk) 17:57, 16 October 2014 (UTC)
replies: text: Since a person in the throws of an episode is extremely lightheaded to the point of unconsciousness (and frequently are unable to think clearly), I strongly suggest that you do NOT require them "to walk it off". As for using the old "smelling salts" (ammonia, these days), what reference do you have for the efficacy of this technique on the vasovagal response besides "old movies"? Thank you, Wordreader (talk) 17:48, 16 October 2014 (UTC)
thread_title:  Walking to prevent syncope 

message: My reading comprehension and vocabulary are higher than the norm, but I could barely read this article. Can we tone down the jargon? This isn't a medical textbook. 184.77.68.158 (talk) 05:25, 26 August 2014 (UTC)
replies: text: I so agree with 184.77.68.158. This article, and most technical/scientific/medical articles on WP that I've read, get top heavy with jargon and minutia on the cellular level. Plain language will increase the article's usability for the casual reader. If readers want to delve deeper, then provide links to jargony terms and/or build up to more complex matter later in the article. Example of a possible change: ". . .is a malaise mediated by the vagus nerve." ---> ". . .is a feeling of unease or dizziness caused by a nerve that originates in the brain, the vagus nerve"?  Thank you, Wordreader (talk) 06:16, 10 September 2014 (UTC)
thread_title:  Readability 

message: The article currently says:
  "The autonomic nervous system's physiologic state (see below) leading to      loss of consciousness may persist for several minutes, so:     If sufferers try to sit or stand when they wake up, they may pass out again     The person may be nauseated, pale, and sweaty for several minutes or hours"
This is confusingly vague, and unsourced. My experience is that an episode of of vasovagal response typically lasts 3-15 minutes, but can persist indefinitely, at least a couple hours. What good sources are there for improving this aspect of the article? -96.233.20.129 (talk) 15:01, 19 October 2014 (UTC)
thread_title:  Duration: minutes vs. hours 

message: The article itemizes many relevant particular causes that are associated with this reaction, but does not group them in a meaningful way nor mention the underlying commonality. A major cause of this response is a deeply embedded physiological response to a category of perceived (physical) threats.
These are all potential members of this cluster:
* During or post-biopsy procedures.
* Stress directly related to trauma
* Any painful or unpleasant stimuli, such as:
** Trauma (such as hitting one's funny bone)
** Watching or experiencing medical procedures (such as Venipuncture or Injection (medicine))
* Sensitivity to pain
* In health care, such as nursing care, digital rectal procedures (e.g., digital disimpaction)
* The sight of blood
The phrase "painful or unpleasant stimuli" is particularly potentially misleading. The flavor is quite different from the concept of a perceived serious "threat". Pain is physical. But this response is triggered not by physical pain per se (within this threat-cluster) but rather by the brain being aware and thinking about ideas (being poked by something sharp, for example). So, a person with this threat-cluster reaction might not react to some severe pain experiences, if they were not perceived as real threats, yet might react to an injection -- even an injection that turned out to be nearly painless -- because the idea of being poked by a needle seems too (life-) threatening. Or again, just hearing people chat about medical procedure horrible experiences could be unbearable, because thinking about such things is too vividly-real-threatening.
The closest the article currently comes to properly wording this aspect is:
  exposure-based exercises with therapists if the trigger is mental or emotional, e.g. sight of blood.
-96.233.20.129 (talk) 16:05, 19 October 2014 (UTC)
thread_title:  Response to perceived threat 

message: A friend of mine, who passed away some time ago, had a condition he called "vasovagal" but it does not sound like the symptoms that this article is describing. His symptoms (as I recall) included heart problems (arythmia I think ?), digestive problems (he never really described these in detail but I would say "indigestion" and "heartburn/angina" would be a layman's description), and occasional sudden fatigue requiring him to rest for a while (which of course may be a side effect of the heart issues). There were other issues too like high blood pressure and some specific pains but its been too long and I don't remember the details. I do remember he was not allowed to undergo anasthesia for surgery without extra precautions. But as far as I know he never had anything like fainting (syncope) events.
* QUESTION 1: Is there a different vasovagal response condition and if so what is that called medically to differentiate from syncope? Could it be this?
I remember he said he had lived with this condition for many decades and had eventually learned that his condition was caused by a botched colonoscopy procedure that damaged ("nicked") the nerve. I know he was tested at a UCLA medical facility some years ago and he had a severe ("near fatal") response to the tilt-table. I also remember he often had to show other doctors his meical report from those tests because many doctors did not believe such a condition existed (apparently it is considered a fantasy illness by some doctors). One doctor went so far as to actually accused him of faking the report but the doctor eventually apologized after calling UCLA and talking with someone there. I was not in the doctor's office when this happened but I remember how mad he was for a couple of days until the doctor called him to say sorry.
* QUESTION 2: Why are doctors so resistant to whatever this condition is?
Searching the web I see several references about the cause-effect relationships between colonoscopy and vasovagal response. I am not a medical person so I do not understand half the stuff I read. See these just for starters.
* QUESTION 3: Why is there absolutely no mention of colonoscopy in this article if there is a documented correlation between the two?
Just curious but also maybe this stuff needs to be in the article somehow? especially #3. 104.32.193.6 (talk) 12:16, 8 November 2014 (UTC)
thread_title:  Other vasovagal condition ??? 

message: QJM doi:10.1093/qjmed/hcw089 JFW | T@lk 15:31, 29 December 2016 (UTC)
thread_title:  Review 

message: Unclear were the ref says 
"Food poisoning (e.g. Salmonella, etc)"
Is a cause of reflex syncope? Doc James (talk · contribs · email) 16:02, 14 November 2017 (UTC)
replies: text: This ref says "shock and syncope in a patient with uncontrolled diabetes" which means that it is LOC due to low BP that is not transient. Doc James (talk · contribs · email) 16:03, 14 November 2017 (UTC)
thread_title: Support

message: This is not generally true. Apart from possible injuries due to falls, it depends on the frequency of the syncopes if they do harm or not. If someone keeps fainting very often (e.g. multiple times per hour) for a long time, this is for sure not harmless and may result in chronic brain damage, among other problems. If however the fainting attacks are infrequent (like once in a week) they may be innocuous apart from causing falls. --79.240.195.252 (talk) 15:25, 19 August 2018 (UTC)
replies: text: Welcome to Wikipedia. They way we work is that we base stuff on high quality references per WP:MEDRS. You will need to provide a reference. Best Doc James (talk · contribs · email) 00:33, 20 August 2018 (UTC)
replies: text: If you look for sources about potential complications of transient drops in blood pressure, see the chapter "prognosis" in our article about orthostatic hypotension, for example. This is not the same as reflex syncope, but severe reflex syncope may mimic it by way of frequent episodes of fainting under minimal stress. However this should be rare, and orthostatic hypotension is usually a more severe condition and more likely to cause damage. I think it's about the statement that syncopes are generally always harmless - this is normally the case in reflex syncope, but a reader may over-generalize this statement in a wrong way. In some conditions they are not, especially if they are due to heart disease. --130.83.182.70 (talk) 11:21, 20 August 2018 (UTC)
thread_title:  "brief periods of unconsciousness do no harm" 

message: I commend this article as of 2019: many up-to-date sources are included now. Zezen (talk) 05:31, 25 April 2019 (UTC)
thread_title:  Useful and in good shape