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CASE REPORT
In-flight syncope as the first manifestation of severe cardiodepressive vaso-vagal syndrome, verified by tilt-table testing with delayed response
1
Department of Internal Medicine and Internal Nursing, Faculty of Health Sciences, Medical University, Lublin, Poland
2
Department of Cardiology, Medical University, Lublin, Poland
3
Department of Cardiology, Specialist Hospital, Puławy, Poland
Corresponding author
Anna Wysocka
Department of Internal Medicine and Internal Nursing, Faculty of Health Sciences, Medical University of Lublin,, Chodzki 7, 20-093, Lublin, Poland
Department of Internal Medicine and Internal Nursing, Faculty of Health Sciences, Medical University of Lublin,, Chodzki 7, 20-093, Lublin, Poland
KEYWORDS
TOPICS
ABSTRACT
A 66-year-old woman with a history of in-flight sedentary syncope, with normal results of ambulatory diagnostics, was referred to Clinical Electrocardiology Department for invasive electrophysiology study.The study revealed normal parameters, with no arrhythmia induced; a head-up tilt-test was performed, resulting in type I response with mild bradycardia and transient symptoms. After being released from the tilt-table, and while in the sitting position, she experienced full syncope with 20 s episode of complete A-V block recorded. The diagnosis was verified to type IIB syncope and the patient was implanted with dual-chamber pacemaker. Syncope is one of the most frequent medical in-flight emergencies; however, it is predominantly linked with disturbed autonomic system response to hypobaric hypoxia. During tilt-table testing, the described delayed cardiodepressive response was very unusual, it can still lead to accurate diagnosis and effective treatment, with no recurrent
symptoms.
REFERENCES (21)
1.
Martin-Gill C, Doyle TJ, Yealy DM. In-Flight Medical Emergencies: A Review. JAMA. 2018;320:2580–2590. doi:10.1001/jama.2018.19842; PMID: 30575886.
2.
Borges do Nascimento IJ, Jerončić A, Arantes AJR, et al. The global incidence of in-flight medical emergencies: A systematic review and meta-analysis of approximately 1.5 billion airline passengers. Am J Emerg Med. 2021;48:156–164. doi:10.1016/j.ajem.2021.04.010.
3.
Jardine DL, Wieling W, Brignole M, et al. The pathophysiology of the vasovagal response. Heart Rhythm. 2018;15:921–929. doi:10.1016/j.hrthm.2017.12.013; PMID: 29246828; PMCID: PMC5984661.
4.
Cheshire WP Jr, Goldstein DS. Autonomic uprising: the tilt table test in autonomic medicine. Clin Auton Res. 2019;29:215–230. doi:10.1007/s10286-019-00598-9; PMID: 30838497; PMCID: PMC8897774.
5.
Brignole M, Menozzi C, Del Rosso A, Costa S, Gaggioli G, Bottoni N, et al. New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Vasovagal Syncope International Study. Europace. 2000;2(1):66–76. doi:10.1053/eupc.1999.0064; PMID: 11225598.
6.
Kingsley T, Kirchoff R, Newman JS, et al. Demystifying airline syncope. World J Cardiol. 2020;12:107–109. doi:10.4330/wjc.v12.i3.107; PMID: 32280429; PMCID: PMC7138867.
7.
Błaszczyk RT, Gorlo A, Dukacz M, et al. Association between exposure to air pollution and incidence of atrial fibrillation. Ann Agric Environ Med. 2023;30:15–21. doi:10.26444/aaem/157189; PMID: 36999851.
8.
Seccombe LM, Peters MJ. Physiology in medicine: acute altitude exposure in patients with pulmonary and cardiovascular disease. J Appl Physiol. (1985). 2014;116(5):478–85. doi:10.1152/japplphysiol.01013.2013.
9.
Furian M, Tannheimer M, Burtscher M. Effects of Acute Exposure and Acclimatization to High-Altitude on Oxygen Saturation and Related Cardiorespiratory Fitness in Health and Disease. J Clin Med. 2022;11:6699. doi:10.3390/jcm11226699; PMID: 36431176; PMCID: PMC9697047.
10.
Chandra A, Conry S. In-flight Medical Emergencies. West J Emerg Med. 2013;14:499–504. doi:10.5811/westjem.2013.4.16052; PMID: 24106549; PMCID: PMC3789915.
11.
Corvino AR, Russo V, Monaco MGL, et al. Vasovagal Syncope at Work: A Narrative Review for an Occupational Management Proposal.Int J Environ Res Public Health. 2023;20(8):5460. doi:10.3390/ijerph20085460; PMID: 37107742; PMCID: PMC10138125.
12.
Chee JN, Simpson C, Sheldon RS, et al. A Systematic Review of the Risk of Motor Vehicle Collision in Patients With Syncope. Can J Cardiol. 2021;37:151–161. doi:10.1016/j.cjca.2020.02.070; PMID: 32504546.
13.
Chiang KT, Yang CS, Chiou WY, et al. Repeated hypoxic syncope in a helicopter pilot at a simulated altitude of 18,000 feet. Aviat Space Environ Med. 2012;83:609–13. doi:10.3357/asem.3273.2012; PMID: 22764617.
14.
Manen O, Perrier E, Généro M. Ground vasovagal presyncopes and fighter pilot fitness: aeromedical concerns. Aviat Space Environ Med. 2011;82(9):917–20. doi:10.3357/asem.2620.2011; PMID: 21888279.
15.
Brignole M, Moya A, de Lange FJ, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39:1883–1948. https://doi.org/10.1093/eurhea....
16.
Glikson M, Nielsen JC, Kronborg MB, et al. ESC Scientific Document Group. 2021 ESC Guidelines on cardiac pacing and cardiac esynchronization therapy. Eur Heart J. 2021;42(35):3427–3520. doi:10.1093/eurheartj/ehab364.
17.
Barón-Esquivias G, Barón-Solís C, Ordóñez A. Pacing for patients suffering from cardioinhibitory vasovagal syncope using the closed-loop system. Front Cardiovasc Med. 2020;6:192. doi:10.3389/fcvm.2019.00192; PMID: 32118042; PMCID: PMC7033422.
18.
Akella K, Olshansky B, Lakkireddy D, Gopinathannair R. Pacing Therapies for Vasovagal Syncope. J Atr Fibrillation. 2020;13:2406. doi:10.4022/jafib.2406; PMID: 33024506; PMCID: PMC7533132.
19.
van Dijk JG, van Rossum IA, van Houwelingen M, et al. Influence of Age on Magnitude and Timing of Vasodepression and Cardioinhibition in Tilt-Induced Vasovagal Syncope. JACC Clin Electrophysiol. 2022;8(8):997–1009. doi:10.1016/j.jacep.2022.05.009; Epub 2022 Jul 27; PMID: 35981805.
20.
Piotrowski R, Baran J, Sikorska A, et al. Cardioneuroablation for Reflex Syncope: Efficacy and Effects on Autonomic Cardiac Regulation-A Prospective Randomized Trial. JACC Clin Electrophysiol. 2023;9:85–95. doi:10.1016/j.jacep.2022.08.011; pub 2022 Aug 28; PMID: 36114133.
21.
Li L, Po S, Yao Y. Cardioneuroablation for treating vasovagal syncope: current status and future directions. Arrhythm Electrophysiol Rev. 2023;12:e18. doi:10.15420/aer.2023.02; PMID: 37457436; PMCID: PMC10345939.
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