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[Blood pressure change and syncope during leg phlebography]
J Koizumi1, S Hori, Y Shinozawa
1Department of Emergency Medicine, School of Medicine, Keio University.
Nihon Igaku Hoshasen Gakkai Zasshi. Nippon Acta Radiologica
|August 25, 1994
Summary
Syncope attacks during leg phlebography, characterized by a significant drop in blood pressure, suggest a vasovagal reaction. Further research is needed to explore influencing factors like premedication and contrast media.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
Background:
- Syncope, characterized by transient loss of consciousness, can occur during medical procedures.
- The incidence and mechanisms of syncope during leg phlebography are not well-documented.
Purpose of the Study:
- To investigate the incidence and potential mechanisms of syncope during leg phlebography.
- To identify factors that may contribute to syncope during this procedure.
Main Methods:
- Noninvasive blood pressure and ECG monitoring were used in 21 patients undergoing leg phlebography in an upright position.
- Patient demographics, medical history, and procedural details were recorded.
Main Results:
- Syncope occurred in 14.3% of cases (12.1% of limbs), with onset during or after contrast medium infusion or venous return evaluation.
- During syncope, systolic blood pressure dropped below 80 mmHg, accompanied by significant decreases in systolic blood pressure and heart rate, indicative of a vasovagal response.
- Non-syncope patients also exhibited significant hemodynamic changes, suggesting a predisposition to vasovagal excitation.
Conclusions:
- Vasovagal reaction is the likely mechanism for syncope during leg phlebography.
- Premedication, contrast media, and patient positioning may play crucial roles in the occurrence of syncope and warrant further investigation.