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Sleep Fainting: A Neurocardiogenic Entity

Fainting is a common clinical presentation, with vagally mediated (neurocardiogenic) causes being the most common for syncope presentation to the emergency room, and for hospital admissions. Classic teaching is that upright posture is a prerequisite for vagally mediated syncope (VMS) and that syncop...

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Autores principales: Shahab, Hunaina, Sonawalla, Ambreen A, Khan, Maryam, Qureshi, Aman, Khan, Aamir H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388817/
https://www.ncbi.nlm.nih.gov/pubmed/30820371
http://dx.doi.org/10.7759/cureus.3751
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author Shahab, Hunaina
Sonawalla, Ambreen A
Khan, Maryam
Qureshi, Aman
Khan, Aamir H
author_facet Shahab, Hunaina
Sonawalla, Ambreen A
Khan, Maryam
Qureshi, Aman
Khan, Aamir H
author_sort Shahab, Hunaina
collection PubMed
description Fainting is a common clinical presentation, with vagally mediated (neurocardiogenic) causes being the most common for syncope presentation to the emergency room, and for hospital admissions. Classic teaching is that upright posture is a prerequisite for vagally mediated syncope (VMS) and that syncope in the supine position has more sinister causes. We present five patients, three males and two females, with a mean age of 44.4 (range 29–67) years, who presented with VMS in the supine position (sleep fainting). Four patients also had a history of classic upright syncope. Based on their clinical features and thorough investigations, we excluded other causes of loss of consciousness and diagnosed these patients to be having VMS in the supine position (sleep fainting). We further describe the management and follow-up of these patients. Sleep fainting/syncope is a new entity and has to be recognized for appropriate management. A diagnosis can be established if there is clinical suspicion, preserved left ventricular function without evidence of coronary artery disease, no high-risk electrocardiographic evidence of pre-excitation, long or short QT syndrome, Brugada syndrome or arrhythmogenic right ventricular dysplasia, and normal neurological work-up.
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spelling pubmed-63888172019-02-28 Sleep Fainting: A Neurocardiogenic Entity Shahab, Hunaina Sonawalla, Ambreen A Khan, Maryam Qureshi, Aman Khan, Aamir H Cureus Cardiology Fainting is a common clinical presentation, with vagally mediated (neurocardiogenic) causes being the most common for syncope presentation to the emergency room, and for hospital admissions. Classic teaching is that upright posture is a prerequisite for vagally mediated syncope (VMS) and that syncope in the supine position has more sinister causes. We present five patients, three males and two females, with a mean age of 44.4 (range 29–67) years, who presented with VMS in the supine position (sleep fainting). Four patients also had a history of classic upright syncope. Based on their clinical features and thorough investigations, we excluded other causes of loss of consciousness and diagnosed these patients to be having VMS in the supine position (sleep fainting). We further describe the management and follow-up of these patients. Sleep fainting/syncope is a new entity and has to be recognized for appropriate management. A diagnosis can be established if there is clinical suspicion, preserved left ventricular function without evidence of coronary artery disease, no high-risk electrocardiographic evidence of pre-excitation, long or short QT syndrome, Brugada syndrome or arrhythmogenic right ventricular dysplasia, and normal neurological work-up. Cureus 2018-12-18 /pmc/articles/PMC6388817/ /pubmed/30820371 http://dx.doi.org/10.7759/cureus.3751 Text en Copyright © 2018, Shahab et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Shahab, Hunaina
Sonawalla, Ambreen A
Khan, Maryam
Qureshi, Aman
Khan, Aamir H
Sleep Fainting: A Neurocardiogenic Entity
title Sleep Fainting: A Neurocardiogenic Entity
title_full Sleep Fainting: A Neurocardiogenic Entity
title_fullStr Sleep Fainting: A Neurocardiogenic Entity
title_full_unstemmed Sleep Fainting: A Neurocardiogenic Entity
title_short Sleep Fainting: A Neurocardiogenic Entity
title_sort sleep fainting: a neurocardiogenic entity
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388817/
https://www.ncbi.nlm.nih.gov/pubmed/30820371
http://dx.doi.org/10.7759/cureus.3751
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