4.6 Review

Vasovagal syncope: An overview of pathophysiological mechanisms

Journal

EUROPEAN JOURNAL OF INTERNAL MEDICINE
Volume 112, Issue -, Pages 6-14

Publisher

ELSEVIER
DOI: 10.1016/j.ejim.2023.03.025

Keywords

Syncope; Vasovagal sincope; Baroreflex; Vagus nerve; Cerebral hypoperfusion; Transient loss of consciousness; Gut microbiota

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Syncope is a short-term transient loss of consciousness with rapid onset and complete spontaneous recovery. Vasovagal syncope (VVS) is the most common form, characterized by global cerebral hypoperfusion due to inadequate blood supply to the brain. Although VVS is generally harmless, its frequent occurrence can negatively impact quality of life and increase the risk of adverse events. Understanding the multifaceted nature of VVS is crucial for developing preventative strategies.
Syncope is a short-term transient loss of consciousness, characterized by rapid onset and complete spontaneous recovery. According to the 2018 European Society of Cardiology guidelines, three different types of syncope have been identified. However, all forms of syncope share a common final pathophysiological event, global cerebral hypoperfusion, which results from the inability of the circulatory system to maintain blood pressure at the level required to efficiently supply blood to the brain. The vasovagal syncope (VVS) is the most common form of syncope. Although, VVS is generally harmless, its frequent occurrence can negatively affect quality of life and increase the risk of adverse events. The pathophysiological mechanisms underlying VVS remain obscure. The multifaceted nature of VVS presents a veritable challenge to understanding this condition and developing preventative strategies. Thus, the aim of this review was to discuss the factors contributing to the pathogenesis of VVS and provide guidance for future research.

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