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Abstract

Vasovagal syncope (VVS) is the most common cause of recurrent syncope which has a good prognosis, but has a high morbidity. structural heart disease is absent in most of the patients. It is thought to be the result of neurocardiovascular system abnormality which provides the systemic and cerebral perfusion. Although VVS has a high incidence, no satisfactory treatment has been found yet. The main purpose of the treatment is to prevent the recurrent syncope episodes and injuries that may occur due to syncope and to improve the quality of life. Treatment of VVS is divided into three as nonpharmacological treatment, pharmacological treatment and cardiac pacemaker implantation. The treatment of VVS is difficult. The patient should be given detailed information about the disease, proper diet should be recommended by the life-style changes, triggerering factors of the syncope should be explained and advised to avoid these triggers. Psychological support is very important and should be maintained in these patients. Patients should be strongly encouraged to implement physical maneuvers. Medical treatment can be tried if the patients’ complaints continue. In case of recurrent syncope despite ongoing medical treatment, permanent pacemaker implantation should be considered

Keywords

• Neurocardiovascular, syncope

Vasovagal Senkobun Tedavisi

Öz

Özet: Rekürren senkobun en sık nedeni olan Vazovagal Senkop (VVS), prognozu iyi olmakla birlikte yüksek morbiditeye sahiptir. Hastaların çoğunda yapısal bir kalp hastalığı yoktur. Bu hastalığın sistemik ve serebral perfüzyonu sağlayan nörokardiyovasküler sistemin anormalliği sonucu oluştuğu düşünülmektedir. VVS’un insidansı yüksek olmakla birlikte, henüz tedavisi tatmin edici düzeyde değildir. Tedavideki temel amaç, hastanın senkop rekürrenslerini ve senkoba bağlı oluşabilecek sakatlıkları önlemek, yaşam kalitesini artırmaktır. VVS’un tedavisi, non-farmakolojik tedavi, farmakolojik tedavi ve kardiyak pacemaker uygulaması olarak üç sınıfta toplanmaktadır. VVS’nin tedavisi zorludur. Hastaya, hastalığı ile ilgili ayrıntılı bilgi verilmeli, uygun diyete göre yaşam şekli değişikliği önerilmeli, senkobu tetikleyen faktörler iyi anlatılmalı ve bunlardan kaçınması tavsiye edilmelidir. Bu hastalarda psikolojik destek çok önemlidir ve mutlaka sağlanmalıdır. Fiziksel manevraların uygulanması için hastalar ciddi şekilde teşvik edilmelidir. Bu önerilere rağmen şikayetleri devam eden hastalarda medikal tedavi seçenekleri denenebilir. Medikal tedaviye rağmen senkop rekürrensleri devam eden hastalarda kalıcı pacemaker tedavisi seçenek olarak düşünülmelidir. Abstract: Vasovagal syncope (VVS) is the most common cause of recurrent syncope which has a good prognosis, but has a high morbidity. structural heart disease is absent in most of the patients. It is thought to be the result of neurocardiovascular system abnormality which provides the systemic and cerebral perfusion. Although VVS has a high incidence, no satisfactory treatment has been found yet. The main purpose of the treatment is to prevent the recurrent syncope episodes and injuries that may occur due to syncope and to improve the quality of life. Treatment of VVS is divided into three as non-pharmacological treatment, pharmacological treatment and cardiac pacemaker implantation. The treatment of VVS is difficult. The patient should be given detailed information about the disease, proper diet should be recommended by the life-style changes, triggerering factors of the syncope should be explained and advised to avoid these triggers. Psychological support is very important and should be maintained in these patients. Patients should be strongly encouraged to implement physical maneuvers. Medical treatment can be tried if the patients’ complaints continue. In case of recurrent syncope despite ongoing medical treatment, permanent pacemaker implantation should be considered.

Anahtar Kelimeler

• Nörokardiyovasküler, senkop

Kaynakça

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