reflex syncope
Introduction
Introduction to reflective syncope Reflex syncope due to blood pressure regulation, heart rate reflex arc dysfunction and autonomic dysfunction caused a sudden drop in blood pressure, sudden decrease in cardiac output, causing transient cerebral insufficiency, causing transient loss of consciousness. Such as vasovagal reflex syncope, should avoid mental stress, physical fatigue, standing too long, hot bath time is too long and standing up too fast and other predisposing factors. If it is urinary syncope, do not overdo it, urinate too much or urinate. If the carotid sinus reflex is allergic syncope, the collar should not be too tight, the neck should be slow. If syncope has occurred, it is best to let the patient lie flat on the ground, so that the cardiovascular system does not have to fight gravity, and the patient's body is turned to one side to avoid aspiration. It is wrong to make people sit after fainting, because blood can't be used. Do not flow up to the brain. basic knowledge The proportion of sickness: 0.004% - 0.006% Susceptible people: no specific population Mode of infection: non-infectious Complications: coma
Cause
Cause of reflex syncope
Cause:
Blood pressure regulation, heart rate reflex arc dysfunction and autonomic dysfunction lead to a sudden drop in blood pressure and a sudden decrease in cardiac output, causing a transient lack of blood supply to the brain.
Prevention
Reflex syncope prevention
Acupuncture therapy
1) Body acupuncture: Acute episodes of liver and yang dizziness can be acupuncture at Tai Chong points and diarrhea. Qi and blood dizziness, optional spleen, Shenshu, Guanyuan, Zusanli and other points, take supplement or moxibustion. For those who have liver yang, you can use the wind pool, the line, the Xiaxi and other points to take the diarrhea method. Those who have liver and kidney yin deficiency, plus stab liver Yu, Shenshu use supplement. Those who are turbid and obstructive, can choose Neiguan, Fenglong, Jiexi and other points, using the diarrhea method. All kinds of acute syndromes of vertigo can be acupuncture and Baihui points.
2) Auricular acupuncture: use kidney, Shenmen, pillow, inner ear, subcortical. Take 2. 3 points each time, medium and strong stimulation, leave the needle for 30 minutes, intermittently. Once a day, 5-7 days for a course of treatment.
3) Scalp: Select the bilateral fainting area, once a day, 5 to 10 days for a course of treatment.
2. Chinese medicine liquid therapy
Tablets are now generally used. Pills and some Western medicine treatments. It is precisely the most beneficial to absorb the mixture. Based on the middle-aged and elderly people is not conducive to absorption. The use of mixture treatment is the best. Such as: Tianma dizzy Ning mixture.
3. Chinese medicine
1) Liver yang upper sputum: vertigo with red face red, mouth bitter and irritated, severe numbness, dizziness, servant, headache, language disadvantage, nausea and vomiting, red tongue yellow, pulse string number.
Governing Law: Pinggan Qianyang.
Recipe: 10 grams of gastrodia elata, 10 grams of Uncaria, 30 grams of stone cassia, 30 grams of raw oysters (first fried), 30 grams of glutinous rice (first fried), 10 grams of Sichuan achyranthes, 10 grams of motherwort, 10 grams of astragalus, mountain 10 grams, 10 grams of Eucommia, 12 grams of mulberry parasitic, 12 grams of scorpion.
2) turbidity and resistance: vertigo with head fainting, chest tightness and fatigue, poor appetite, or spitting, greasy fur, slippery pulse.
Governing Law: Activating blood and sputum.
Recipe: Angelica 15g, raw land 15g, peach kernel 6g, safflower 6g, red peony 6g, clam shell 10g, Bupleurum 6g, Campanulaceae 6g, Chuanxiong 6g, Achyranthes 6g, Tianma 6g .
4) Insufficient kidney essence: dizziness with tinnitus, nocturnal emission, weak waist and knees, impotence, tender red tongue, little or no moss, weak pulse.
Governing Law: Kidney filling and filling.
Recipe: 15 grams of Codonopsis pilosula, 12 grams of rehmannia, 12 grams of medlar, 12 grams of asparagus, 12 grams of Ophiopogon, 10 grams of Chaihe, 15 grams of turtle shell (first fried), 12 grams of Eucommia, 12 grams of Achyranthes, 6 grams of Cork 10 grams of dodder, 10 grams of medlar, 10 grams of hawthorn meat, 10 grams of medlar, 10 grams of early lotus.
5) qi and blood deficiency: dizziness is aggravated after the activity, Shen is short of fatigue, face is less Hua, anorexia, pale tongue, thin pulse or virtual.
Governing Law: Replenishing qi and nourishing the spleen.
Recipe: 15 grams of ginseng (other fried people), 25 grams of astragalus, 12 grams of Chinese angelica, 12 grams of Atractylodes, 12 grams of medlar, 12 grams of Chuanxiong, 12 grams of white peony, 12 grams of rehmannia, 6 grams of cinnamon, 12 grams of Achyranthes, 10 grams of licorice.
6) Acupuncture treatment: main points: wind pool (double), Baihui, Yintang, Hegu (double), human middle, sleeping (double), Tai Chong. Acupoints: nausea with vomiting, Jia Neiguan, Shenmen, Zusanli; tinnitus plus hurricane, listening to the palace, rate valley, Zhongmu.
Governing Law: spleen.
Recipe: 10 grams of Pinellia, 10 grams of Atractylodes, 10 grams of Tianma, 10 grams of orange red, 10 grams of medlar, 2 grams of ginger, 6 grams of jujube, 6 grams of licorice.
3) Internal resistance of congestion: vertigo with headache, pain is fixed, palpitations are bored, fatigue is weak, lips and tongue are dark purple or tongue is smeared, pulse string sputum or fine sputum.
Complication
Reflex syncope complications Complications
Those who are severely responsive can cause unnecessary damage after the fainting falls. For the elderly, it may induce aggravation of chronic diseases, and complications are life-threatening.
Symptom
Reflex syncope symptoms common symptoms syncope vasovagal syncope vagination during vomiting, syncope, syncope, carotid sinus syncope, hyperventilation, causing syncope
Reflective syncope is more common:
Vagus vasomotor syncope, the most common cause of sudden fainting of young people, is more common in frail young women, often under the incentives of pain, fear, emotional stress, bleeding, etc., may have prodromal symptoms. More when standing. Some cases may have panic symptoms such as panic and irritability, accompanied by an increase in blood pressure, an increase in heart rate, followed by a slowing of heart rate, a drop in blood pressure, a pale face and a cold sweat, and consciousness may be lost for a few seconds to a few minutes. However, the above symptoms can quickly disappear after lying down. An upright tilt test can be performed.
Carotid sinus syncope is rare. When the neck or neck is pressed, sudden seizures occur. According to the different reactions of massage carotid sinus, it can be divided into two types: type I, reflexive cardiac arrest, leading to fainting; type II, causing severe vascular inhibitory reaction, slow heartbeat, decreased blood pressure, and thus fainting But there is no cardiac arrest. Type II is relatively rare, often a symptom caused by compression of the neck tumor and stimulation of the glossopharyngeal nerve fibers.
Urinary syncope occurs during urination or after urination; it is more common in adult men with nocturia. When they wake up at midnight, they suddenly fall down and waking up for 1 to 2 minutes. Sudden contraction of the bladder due to swelling causes strong vagal reflex to inhibit cardiac and reflex vessels. At the same time, due to bladder emptying, abdominal pressure drops sharply, blood flow to the heart is reduced and transient cerebral ischemia. Reflex syncope can also occur after swallowing, glossopharyngeal neuralgia, and severe dry cough.
Examine
Reflex syncope examination
Electrocardiogram and cardiac B-ultrasound are suitable for cardiogenic syncope. Head CT, cerebral angiography, cerebrospinal fluid examination, cervical X-ray film and carotid artery and vertebral artery B-ultrasound are suitable for brain-borne syncope. More normal EEG.
Diagnosis
Diagnosis and diagnosis of reflex syncope
(1) Reflex syncope: It is the most common type of syncope, accounting for about 90% of the total number of syncope.
1 vasovagal reflex syncope (simple syncope). Mostly caused by irritation, grief, fright, sultry, acupuncture, intravenous injection, tooth extraction, minor surgery and other stimuli. It is caused by a decrease in heart rate or a decrease in blood pressure and a decrease in cerebral blood flow by nerve reflex.
2 urinary syncope. More common in adult males, it happens after waking up after waking up or just after the end, may be with the bladder emptying, the pressure in the basin, abdominal cavity, a large amount of blood flow into the basin, abdominal cavity, and vagus nerve reflex vessels caused by bladder contraction Expansion, decreased blood pressure and decreased cerebral blood flow.
3 upright hypotension syncope. Often occurs after transitioning from a lying position to an upright position or standing for too long. It is associated with a sharp decrease in blood pressure caused by a decrease in sympathetic function such as an increase in reflex heart rate and an increase in blood pressure. More common in long-term bed rest, taking guanethidine, chlorpromazine, levodopa and other drugs, after sympathectomy, diabetic neuropathy, spinal cord spasm, syringomyelia and primary orthostatic hypotension and other neurological diseases And patients with low blood volume caused by severe varicose veins of the lower extremities.
4 carotid sinus reflex allergic syncope. Carotid atherosclerosis and inflammation, tumor, trauma, etc. adjacent to the carotid sinus can make the carotid sinus reflex allergic. When the neck and collar are too tight, the brachial sinus can induce bradycardia or (and) blood pressure. Falling and causing syncope. Syncope can also occur spontaneously.
5 coughing syncope. Often happening suddenly in the cough. It may be related to an increase in intrathoracic pressure when coughing in patients with emphysema or other chronic obstructive pulmonary disease, which prevents venous blood from returning to the heart and causing a decrease in acute cardiac output.
(2) Cardiac syncope: It is the most serious type of syncope. Associated with a reduction in acute cardiac output due to heart disease.
1 arrhythmia. Most occur in patients with heart disease such as complete atrioventricular block, paroxysmal tachycardia, bradycardia or cardiac arrest. Sudden onset at any time and position, in addition to loss of consciousness, but also accompanied by epileptic convulsions, pale or cyanosis.
2 coronary atherosclerotic heart disease. Patients with angina and acute myocardial infarction may be caused by myocardial ischemia and episodic arrhythmia.
3 heart bleeding is blocked. Seen in patients with aortic stenosis, severe pulmonary stenosis, etc., syncope occurs when exerting force. Left atrial myxoma syncope occurs more often when the position changes.
4 other. Such as heart disease sinus syndrome and congenital heart disease.
(3) Brain-derived syncope: may be caused by insufficient blood supply to the internal carotid artery or (and) vertebral artery, subarachnoid hemorrhage, hypertensive encephalopathy and aortic arch syndrome. In addition to having a sexual disturbance, it is often accompanied by other signs of damage to the brain.
Differential diagnosis attention is distinguished from epileptic seizures (small episodes), vertigo attacks, and seizures.
