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Exercise-induced vasodepressor syncope in a collegiate wrestler: a case study
Objective:
To present the case of an 18-year-old collegiate wrestler diagnosed with vasodepressor syncope.
Background:
Vasodepressor syncope and the pathophysiologic mechanisms responsible are not fully understood. It is postulated that a sudden, rapid reduction in venous return to the heart allows for quite forceful ventricular contractions. Hypotension, bradycardia, and possible cerebral hypoxia may result, which could cause loss of consciousness.
Differential Diagnosis:
Cardiovascular, neurologic, metabolic, and psychogenic causes.
Treatment:
Pharmacologic therapy of fludrocortisone acetate and potassium chloride was effective. The athlete returned to full activity without restrictions and remained symptom free throughout the remainder of the season.
Uniqueness:
Vasodepressor syncope is usually associated with full syncope. However, this 18-year-old wrestler never fully lost consciousness. His symptoms occurred primarily with exercise.
Conclusions:
The athletic trainer should consider exercise- induced vasodepressor syncope as a possible etiology for those athletes who present with presyncopal episodes.
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