What Are Causes of Neurocardiogenic?

Neurocardiogenic syncope (NCS) is also called vasovagal syncope or neurally mediated syncope. NCS refers to a sudden loss of consciousness, which may result in fainting. The loss of consciousness is usually accompanied by a lower than normal arterial blood pressure and a slow heart rate. NCS is relatively common; approximately 3 percent of all emergency room visits are explained by NCS, and approximately 25 percent of young adults will experience at least one episode of NCS, generally caused by fear, disgust or anxiety.

Symptoms

• Often, NCS occurs when standing. Prior to losing consciousness, an individual may feel tired, nauseous, or weak. He may experience sweating, stomachache, headache, lightheadedness, visual disturbances or vertigo. The person may appear pale, or the skin may have a blueish cast. Vomiting, disorientation and difficulty speaking may accompany or follow the fainting. The symptoms may persist after the person regains consciousness.

Causes

• NCS may be caused by a lack of blood supply in the head or brain, caused by standing up too rapidly. When an individual stands, gravity sends blood to the lower half of the body. Normally, the body adjusts, but those with NCS patients may not be able to adjust as quickly as others. Changes in levels of various chemicals in the plasma within the body may also contribute to NCS. A low level of serotonin may also be present in NCS patients. Serotonin is a neurotransmitter in the brain and nervous system. Low levels of serotonin are generally genetic and/or caused by chemical imbalances within the body. Other studies demonstrate that a high sensitivity to insulin may be responsible for NCS. Insulin sensitivity relates to your bodies ability to produce and process insulin. The bodies sensitivity to insulin may also be genetically determined.

Triggers

• While the above factors explains the general pathology for NCS, some patients also have isolated incidents of fainting or loss of consciousness caused by NCS. Stressful situations or pain may be responsible for triggering these isolated fainting incidents, and/or for trigger an episode in patients with more persistent NCS.

Diagnosis

• A procedure called tilt table testing is generally used to diagnose NCS, however the test is not 100 percent accurate and can result in both false negative results and false positive results. Tilt table testing involves asking the patient to fast overnight. The patient then comes to a physicians office where he or she is asked to lie on a motorized table. The patient is strapped to the table and an IV line is inserted. After laying flat on the table for 15 minutes, the patient is inverted at a 60 to 80 degree angle for approximately 45 minutes. If symptoms develop, the patient is said to have NCS.

Treatment

• A variety of different therapies are used to treat NCS. A small preliminary study suggested that Cardioneuroablation may be useful in treating NCS patients. Cardioneuroblation involves using radiofrequency to stimulate autonomic connections around the heart, in the three main ganglia.

  Maneuvers to counter the effects of NCS are generally a low-cost, low risk treatment recommended to he majority of patients as the first method of treatment. These countermeasures include arm movements and leg movements. Patients who begin to feel symptoms of an episode can grip one hand with the other hand and simultaneously push both arms away from their chests. They can also cross their legs and tense their muscles. Finally, they can sit with their head between their knees for a brief period of time. Long term solutions, like increasing salts and fluids in the diet, can help prevent further episodes from occurring.