Cottier C
Medizinische Abteilung, Regionalspital Burgdorf.
Ther Umsch. 1997 Mar;54(3):120-6.
Vasovagal syncope, also called neurocardiogenic syncope, is common with younger people. It results from an inappropriate, excessive autonomic reflex activity. In the elderly patient the syncope may be provoked by massage of the carotid bodies and is then known as carotid sinus syndrome. The pathogenesis of neurocardiogenic syncope is debated. Sudden vasodilation and/or bradycardia have been attributed to the activation of ventricular mechanoreceptors. The use of betablockers is based on this hypothesis. Head-up tilting at 60 degrees is helpful in the evaluation of syncope. In the therapy of recurrent vasovagal syncope, a thorough information of the patient and an adaptation of behaviour are often successful. Some authors have reported goods results with betablockade, etilefrin or mineralocorticoids. The patient with repeated severe syncopal attacks and asystole may benefit from an implantable DDD pacemaker.
血管迷走性晕厥，也称为神经心源性晕厥，在年轻人中较为常见。它是由不适当的、过度的自主神经反射活动引起的。在老年患者中，晕厥可能由颈动脉体按摩诱发，此时称为颈动脉窦综合征。神经心源性晕厥的发病机制存在争议。突然的血管舒张和/或心动过缓被认为与心室机械感受器的激活有关。β受体阻滞剂的使用基于这一假设。60度头高位倾斜有助于晕厥的评估。在复发性血管迷走性晕厥的治疗中，向患者充分说明情况并调整行为往往会取得成功。一些作者报告使用β受体阻滞剂、乙苯福林或盐皮质激素取得了良好效果。反复发生严重晕厥发作和心搏停止的患者可能受益于植入式DDD起搏器。
