I posted this question under a different title and was hoping that someone might read my question if listed under a more specific title. I have had a few syncopal episodes since January that are totally new to me. I had a hospital stay with 2 EKGs, serial cardiac enzymes, telemetry monitoring for 24 hours, labs, MRI/MRA of brain/neck arteries, a thallium stress test and an echocardiogram, all with no significant findings. I was referred to a cardiologist who told me I have 'classic neurocardiogenic syncope' and has ordered a 24 hour heart monitor, and tells me we will follow up with an event monitor. He explained how the automonic nervous system gets whacky with the heart sending wrong signals to the brain. He recommended things like increasing salt/fluid, etc. I have no history of heart disease or seizures. Are there underlying diseases that can cause this? Should I look at what might be causing the automonic nervous system to be dysfunctional? If so, what would be appropriate. I am one who (rather than treat/mask symptoms) likes to get to the root of 'why'/cause. Thank you so very much.
The underlying mechanism for neurocardiogenic syncope or vaso vagal syncope is activation of the nucleus tractus solitarius in the brain stem by various triggers like hunger, dehydration, stress, extreme emotions, high altitude, and prolonged exposure to heat. This activation leads to enhancement of the parasympathetic nervous system and withdrawal of sympathetic nervous system. This results in drop in heart rate, drop and BP and unconsciousness. There are no underlying diseases which results in this type of a response, it is just that some people are more susceptible to these triggers.
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