Neurally mediated syncope

The dominant feature of neurally mediated syncope (NMS) is loss of consciousness resulting from hypotension, alone or with bradycardia. The causes of NMS have been debated for sixty years and are still not fully understood; it is accepted that there may not be an identifiable physical or psychologic stressor that triggers NMS. Increased availability of certain procedures, such as head-up tilt study and long-term ambulatory event monitoring, provides an opportunity to diagnose NMS more accurately. A case study shows that effective treatment and control of syncope gives patients confidence and independence.