Differential Diagnostics of Vasovagal Fainting, Orthostatic Hypotension and Baroreflex Failure in a Patient With Syncope
https://doi.org/10.18087/cardio.2018.5.10126
Abstract
We present here a case report of recurring fainting due to orthostatic hypotension in a 45-year-old woman with Hodgkin’s’ disease, treated by radiation therapy and resection of cervical lymph node. We discuss difficulties of identification of etiology and mechanisms of orthostatic hypotension as well as possible role of baroreflex failure at the background of the Hodgkin’s’ disease treatment, and vasovagal syncope of which the patient suffered in her youth.
About the Authors
Alexander V. Pevzner
National Medical Research Center for Cardiology
Russian Federation
Russian Federation
N. E. Zyuzina
RUDN University
Russian Federation
Russian Federation
G. I. Kheymets
National Medical Research Center for Cardiology
Russian Federation
Russian Federation
A. N. Rogoza
National Medical Research Center for Cardiology
Russian Federation
Russian Federation
References
1. Moya A., Sutton R., Ammiraty F. et al. Guidelines on management (diagnosis and treatment) of syncope. Eur Heart J. 2009; 21: 2631-2671. DOI: 10.1093/eurheartj/ehp298.
2. Певзнер А. В., Кучинская Е. А. Вазовагальные обмороки. Руководство по нарушениям ритма сердца под редакцией Чазова Е. И., Голицына С. П. Москва, ГЭОТАР-Медиа 2008: 223-245
3. Nwazue V. C., Raj S. R. Confounders of vasovagal syncope: orthostatic hypotension. Cardiol Clin 2013; 31 (1): 89-100. DOI: 10.1016/j.ccl.2012.09.003.
4. Kashihara K. Roles of arterial baroreceptor reflex during Bezold-Jarisch reflex. Curr Cardiol Rev 2009; 5 (4): 263-267. DOI: 10.2174/157340309789317805.
5. Goldstein D. S., Sharabi Y. Neurogenic orthostatic hypotension: a pathophysiological approach. Circulation 2009; 119: 139-146. DOI: 10.1161/CIRCULATIONAHA.108.805887.
6. Ketch T., Biaggioni I., Robertson R. M., Robertson D. Four Faces of Baroreflex Failure: Hypertensive Crisis, Volatile Hypertension, Orthostatic Tachycardia, and Malignant Vagotonia. Circulation 2002; 105: 2518-2523. DOI: 10.1161/01.CIR.0000017186.52382. F4.
7. Rose K. M., Eigenbrodt M. L., Biga R. L. Orthostatic Hypotension Predicts Mortality in Middle-Aged Adults. The Atherosclerosis Risk in Communities (ARIC) Study. Circulation 2006; 114: 630636. DOI: 10.1161./CIRCULATIONAHA.105.598722.
8. Fernandes S.J., Martins O. M., Matoso L. S. The arterial baroreflex effectiveness index in risk stratification of chronic heart failure patients who are candidates for cardiac resynchronization therapy. Rev Port Cardiol 2016; 35 (6): 343-350. DOI: 10.1016/j.repc.2015.11.021.
9. Hare J. M. The dilated, restrictive, and infiltrative cardiomyopathy. In: Braunwald's Heart Disease. A textbook of cardiovascular medicine the 9-th edition. ELSEVIER Saunders. 2012; 1561-1582.
10. Cardell B. S. Role of cytotoxic agents in production of amyloidosis in Hodgkin, s disease. British Medical Journal 1961; 1 (5233); 1145-1148.
11. Kozlowski P., Montgomery S., Befekadu R., Hahn-Strömberg V. The risk of renal disease is increased in lambda myeloma with bone marrow amyloid deposits. J. Blood Med 2017; 8: 29-34. DOI: 10.2147/JBM.S129516.
12. Jordan J. Baroreflex failure. In: ed. Robertson D. Primer on the Autonomic Nervous System. 3d edition. Amsterdam/Boston/Heidelberg/London/NewYork/Oxford/Paris/SanDiego/SanFrancisco/Singapore/Sydney/Tokyo: Elsevier 2012; 349-353.
13. La Rovere M. T., Pinna G. D., Raczak G. Baroreflex sensitivity: measurement and clinical implications. Ann Noninvasive Electrocardiol 2008; 13 (2): 191-207. DOI: 10.1111/j.1542-474X.2008.00219.x.
Review
For citations:
Pevzner A.V., Zyuzina N.E., Kheymets G.I., Rogoza A.N. Differential Diagnostics of Vasovagal Fainting, Orthostatic Hypotension and Baroreflex Failure in a Patient With Syncope. Kardiologiia. 2018;58(5):91-96. (In Russ.) https://doi.org/10.18087/cardio.2018.5.10126
Views:
1139
Email this article 
Post a Comment 
