Cardioinhibitory and vasodepressor responses to different stressors on head-up tilt

We describe the case of a 37-year-old man with a history of laughter-induced syncope, which caused him to crash his car. The patient was a non-smoker with a history of obstructive sleep apnoea and obesity with a body mass index of 33.5. He underwent head up tilt testing with glyceryl trinitrate provocation. On four occasions, the patient was asked to laugh which all ended in a spontaneous vigorous cough after which he started to feel lightheaded. There was concordant drop in systolic BP without any decrease in heart rate (PanelA). At 32  min, there was sinus arrest for 12 seconds and loss of consciousness for 40 seconds (PanelB). This is consistent with a diagnosis of VASIS 2B (cardioinhibitory) vasovagal syncope. However, the more relevant clinical diagnosis was cough/laughter-induced syncope, which had a vasodepressor response.
Source: Europace - Category: Cardiology Source Type: research

Related Links:

Conclusion and Discussion: Our study shows that the treatment by CPAP in obese patients with severe OSAHS doesn’t improve the function of the muscular and cardiorespiratory chain. In addition to CPAP, a pulmonary rehabilitation program training and weight reduction can help us in the care of those patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Publication date: Available online 25 February 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Laurent GuilleminaultAbstractWith respective prevalence of 13% and 9.6%, obesity and chronic cough are two common conditions worldwide. The crucial role of obesity has been highlighted in the development and progression of many respiratory diseases. According to the results of epidemiological studies, obesity, particularly abdominal obesity, may also be associated with chronic cough (CC). CC seems to be more severe in obese patients compared to normal-weight subjects. The management of CC may differ slightly in obe...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
Introduction: Sleep apnea-hypopnea syndrome (SAHS) is defined by the repetitive occurrence of brief apneas during sleep. Our objective is to analyze the clinical and functional profiles of SAHS in elderly obese patientsPatients and methods: We performed a retrospective study of 63 elderly obese patients with SAHS. They were sent for body plethysmography. Anthropometric data and personal history were specified. Clinical data (cough, sputum, exercise dyspnea and nocturnal snoring) have been identified. The plethysmographic data were analyzed. Continuous positive pressure (CPAP) treatment was sought.Results: 63 patients were ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Conclusions: As compatible with previous research, we recognized asthma and PBB as the most frequent causes of chronic cough. We believe that implementation of a standardized algorithm including investigation of OSA as an etiological factor of chronic cough in children may improve clinical outcomes.Figure-1: Etiologies of patients (n=251)*: Three patients were diagnosed as astma and gastroesophageal reflux
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
ConclusionsOur findings provide a basis to support current guideline recommendations for routine symptom screening to identify medical complications among patients with BMI 30  kg/m2 or greater.
Source: Quality of Life Research - Category: Health Management Source Type: research
DiscussionObstructive sleep apnea syndrome (OSAS) is defined as a “disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction (obstructive apnea) that disrupts normal ventilation during sleep and normal sleep patterns.” It is different than primary snoring which is snoring without apnea, sleep arousals, or problems with gas exchange. OSAS symptoms include snoring (often with snorts, gasps or pauses), disturbed sleep (often frequent arousals) and daytime neurobehavioral problems. Sleepiness during the day can occur but is less common in...
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54  years. Symptoms included severe dyspnea, dry cough, recurrent pulmonary infections, and respiratory failure. Fifty percent of patie...
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Discussion Fatigue is a subjective feeling of decreased energy, tiredness or feeling of exhaustion. Lethargy is often used synonymously, but lethargy is a state of being drowsiness or sleepy, and implies mental status changes. Both can cause the person to be apathetic or less active. Fatigue is a common state that almost everyone experiences multiple times in his or her lifetime. For most people it is a relatively acute or short-term chronic problem, often with a relatively easily identifiable problem cause, such as inadequate sleep, acute illness, or overexertion. For some, it can be less readily identifiable such as dep...
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Conclusions:Our cross-sectional study suggests that sleep difficulties are common among Veterans referred to a weight loss program at a Veterans Affairs Hospital. Controlled studies are needed to investigate whether the results are generalizable and whether obesity among veterans is a risk factor for sleep disorders and PTSD.Commentary:A commentary on this article appears in this issue on page 943.Citation:Mayer SB, Levy JR, Farrell-Carnahan L, Nichols MG, Raman S. Obese veterans enrolled in a veterans affairs medical center outpatient weight loss clinic are likely to experience disordered sleep and posttraumatic stress. J...
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
By Brandon R. Peters, MD When sleep is not refreshing, the feelings of tiredness and fatigue can undermine your daytime function. Beyond common sleep disorders like obstructive sleep apnea and insomnia, what are some of the reasons for feeling tired? Explore some of these potential causes, ranging from medications to diet and exercise, and try to discover what you can do to feel better. Understanding the Role of Sleep Disorders First, it is important to recognize that there is a difference between sleepiness and fatigue. Sleepiness is the strong desire for sleep that often immediately precedes falling asleep. It is some...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
More News: Cardiology | Cough | Eating Disorders & Weight Management | Heart | Obesity | Obstructive Sleep Apnea | Sleep Disorders | Sleep Medicine | Smokers