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Related Experiment Videos

Vagal syncope during recurrent pulmonary embolism.

R J Simpson, R Podolak, C A Mangano

    JAMA
    |January 21, 1983
    PubMed
    Summary

    Syncope during pulmonary embolism may stem from a parasympathetic reflex. This reflex causes transient bradycardia and atrioventricular block, leading to fainting episodes.

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    Area of Science:

    • Cardiology
    • Pulmonary Medicine
    • Autonomic Nervous System

    Background:

    • The underlying mechanisms of syncope associated with pulmonary embolism (PE) remain incompletely understood.
    • Pulmonary embolism is a serious condition that can lead to various cardiovascular complications.

    Observation:

    • Two patients experiencing recurrent pulmonary embolism presented with syncope.
    • During these syncopal episodes, both patients exhibited transient sinus bradycardia and atrioventricular (AV) block.
    • Normal sinus rhythm restoration correlated with the return of consciousness.

    Findings:

    • The observed bradyarrhythmia (sinus bradycardia with AV block) during syncope suggests a vagal reflex.
    • This parasympathetic reflex is a known response to increased vagal tone.
    • The simultaneous slowing of sinus rate and development of AV block are characteristic manifestations of heightened vagal activity.

    Implications:

    • This parasympathetic reflex mechanism may frequently contribute to syncope in patients with pulmonary embolism.
    • Understanding this reflex can improve diagnostic approaches and management strategies for PE-related syncope.
    • Further research into cardiac reflexes in PE is warranted to elucidate syncope pathophysiology.

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