The following is a summary of “Adult vasovagal syncope with abdominal pain diagnosed by head-up tilt combined with transcranial doppler: a preliminary study,” published in the April 2024 issue of Neurology by Wang et al.
Researchers conducted a retrospective study investigating the under-recognized link between abdominal pain and vasovagal syncope (VVS) in adults.
They encountered three adult patients experiencing VVS along with presyncopal abdominal pain. Determined through simultaneous multimodal detection (transcranial Doppler [TCD] with head-up tilt [HUT]). Relevant literature for discussion was delved into.
The results showed that in Case 1, a 52-year-old man experienced recurrent decreased consciousness following six months of abdominal pain. Physical examinations yielded no abnormalities. Various tests revealed no abnormalities, including dynamic electrocardiography, echocardiography, head and neck computed tomography angiography, MRI, and video electroencephalogram. Case 2 involved a 57-year-old woman with over 30 years of recurrent syncope accompanied by abdominal pain. Physical examination, electroencephalography, and MRI showed no abnormalities, but echocardiography revealed large right-to-left shunts. In Case 3, a 30-year-old woman experienced recurrent syncope for over 10 years, with abdominal pain as a precursor. Physical examination, laboratory analysis, head computed tomography, electrocardiography, and echocardiography yielded no abnormalities. Syncope secondary to abdominal pain was reproduced during HUT testing. Additionally, HUT revealed vasovagal syncope and synchronous TCD showed decreased cerebral blood flow, leading to a final diagnosis of VVS in all cases.
Investigators concluded that abdominal pain emerged as a potential precursor of VVS in adults, highlighting the need for earlier recognition of syncopal symptoms to guide treatment and improve understanding of the underlying mechanisms.
Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03623-1
