Clinical case of a vasovagal syncope

Syncope is defined as a transient loss of consciousness due to cerebral hypoperfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery of all vital functions without signs of neurological deficits. Syncope is a multidisciplinary medical problem common in clinical practice. As a rule, syncope occurs due to cardiovascular dysfunction of organic or functional origin, which either develops spontaneously or is induced by a trigger. Due to a various etiology differential diagnosis and prognostic evaluation is difficult. This clinical case demonstrates the features of differential diagnosis of vasovagal syncope in a patient with polymorbid pathology and the features of the choice of an adequate management, including recommendations for lifestyle modifications, specialized education regarding prodromal symptoms recognition methods and timely application of countermeasures.

1. Brignole M, Moya A, de Lange FJ, Deharo J, Elliott PM, FanciulliA et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Russian Journal of Cardiology. 2019;(7):130–194. doi:10.15829/1560-4071-2019-7-130-194. In Russian.

2. Dzhioeva ON, Reznik EV, Nikitin IG. Differential diagnostics of syncopal conditions. Cardiovascular Therapy and Prevention. 2019;18(2):76–83. doi:10.15829/1728-8800-2019-2-76-83. In Russian.

3. Shen W-K, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136(5):e60–e122. doi:10.1161/CIR.0000000000000499

4. Berdibekov BSh. Syncope: etiology, pathophysiology, diagnosis and treatment (based on the recommendations of the American and European societies of cardiology). Kreativnaya Kardiologiya = Creative Cardiology. 2017;11(4):361–375. doi:10.24022/1997-3187-2017-11-4-361-375. In Russian.

5. Kuchinskaya EA, Pevzner AV. Lifestyle modification as a method of treatment of vasovagal syncope. Kardiologiia. 2020;60(1):93–98. doi:10.18087/cardio.2020.1n776. In Russian.

6. Pevzner AV, Kuchinskaia EA, Vershuta EV, Al’bitskaia KV, Kheĭmets GI, Tripoten MI et al. Long-term orthostatic and bicycle ergometry exercise tests in differential diagnosis of syncopal conditions of unclear origin. Ter Arkh. 2004;76(11):23–27. In Russian.