Costume TV series
If someone faints
Rely on "point points" or "send a magic trick"
The person who passed out slowly woke up
Unfortunately, reality is not a TV series
Tingting, a 27-year-old girl from Hangzhou (pseudonym)
From the age of 15
It seems to be trapped in a "fainting" spell
Always fainting from time to time
But the reason could not be found
The First Affiliated Hospital of Zhejiang University School of Medicine
She finally found the "magic magic" that could save her
"I'm not weak, why do I always pass out?"
Since the age of 15, Hangzhou girl Tingting has felt as if she is trapped in a spell called "fainting".
"I still remember the first time I passed out, when I was a sophomore in junior high school, just finished the final exam, those days felt tired, tired, flustered feeling, one day I stood at home for about 20 minutes, that feeling of fatigue suddenly hit me again, I felt the blackness in front of my eyes, all of a sudden fainted, I didn't know anything." 」 Tingting said.
At that time, Tingting was an extraordinarily cheerful girl, who loved to learn, loved to make friends, and the atmosphere at home was also very good, she said that she was still a bit "little fat" at that time, not weak, and usually very healthy. Tingting's parents immediately took her to the hospital near her home for examination, drew blood, did magnetic resonance imaging, and CT, but the doctor did not give a diagnosis, only let her go home to rest more, and the pressure of study should not be too much.
Since then, Tingting has fainted for no reason every year, losing consciousness for a long time, sometimes waking up in tens of seconds, sometimes lasting four or five minutes. Especially when the mental pressure is relatively large, such as facing the middle school entrance examination, college entrance examination and other thresholds, almost every day for one or two months, there will be symptoms of blackness and panic in front of the eyes, and when it is serious, it will faint, but in addition, there are no other symptoms, and I have run many hospitals, and I have lived in several hospitals, but I still have not found the reason.
After college, with the reduction of schoolwork pressure, Tingting's irregular syncope situation has improved, but after graduating from college, she entered the society, and with the pressure of work and family, Tingting began to often have symptoms of unprovoked dizziness, blackness in front of her eyes, panic, and even fainting. Although the annual physical examination, Tingting's indicators are normal, but this unprovoked fainting seriously affected her normal life, she never dared to stay alone for a long time, nor did she dare to go to the amusement park and other places that may occur dangerously, and never dared to drive.
In July 2021, Tingting, who had several repeated attacks in a short period of time, once again made up her mind to go to the hospital for treatment, and this time, after many inquiries, she walked into the Cardiology Clinic of the First Affiliated Hospital of Zhejiang University School of Medicine.
It turned out that ta was too "strong"
Yang Jian, deputy chief physician of the Department of Cardiology, received Tingting, read Tingting's previous examination reports, and asked her medical history in detail, and he initially considered that Tingting may be suffering from a disease called "vasovagal syncope". He perfected various examinations for Tingting, excluded cerebral syncope, cardiogenic syncope, orthostatic hypotension and hypoglycemia and other related diseases, and conducted an upright tilt test on her, Tingting test resulted positive, was diagnosed with vasovagal syncope.
Vasovagal syncope refers to a group of syndromes in which vagus nerve activity is enhanced due to decreased sympathetic activity of the heart, resulting in a decrease in cardiac blood output, which in turn leads to sudden ischemia in the brain and induces syncope.
"In layman's terms, it is our vagus nerve that makes our blood pressure lower and our heartbeat slow down, that is, let us 'calm down', and the sympathetic nerve, which makes our blood pressure rise and our heartbeat accelerate, is to make us 'excited', normal people These two nerves can be well 'coordinated', so that we can maintain a normal state, but some people their vagus nerve is 'too strong', which will suddenly lead to his blood pressure is too low, the heartbeat suddenly slows down, resulting in brain hypoxia, a temporary loss of consciousness." , also known as fainting. Deputy Chief Physician Yang Jian patiently explained to Tingting.
For vasovagal syncope, the current treatment methods mainly include drug therapy, upright training, increased intake of water and salt, and pacemaker implantation, but it is difficult to achieve good treatment results. After communicating with Tingting and her family, Deputy Chief Physician Yang Jian performed a minimally invasive operation for her on the catheter ablation treatment (de-neurification) of the atrial vagus ganglion plexus, which is to locate the atrial vagus ganglion plexus through high-frequency stimulation or anatomical methods, and use the radiofrequency ablation catheter to ablate these areas, so that the vagus nerve is no longer so "strong", so as to effectively treat vasovagus neurotic syncope.
Yang Jian, deputy chief physician, is in the process of surgery
After the operation, until now, Tingting has not had another episode of syncope, nor has she experienced symptoms of panic and blackening in front of her eyes. The retest for upright tilt test 3 months postoperatively has been negative. "Patients still need regular follow-up, and consider whether they need to be ablated again according to the actual situation." Deputy Chief Physician Yang Jian said.
When these symptoms appear, you have to be vigilant
"Syncope refers to a sudden onset of a short loss of consciousness that can be caused by cardiovascular disease, neurological diseases, and metabolic diseases, but there is another category that belongs to 'unexplained syncope'. With the development of medical technology, we found that vasovagal syncope is the most common cause of unexplained syncope, accounting for about 60% of the total number of clinical syncope, which can affect 1% of the population. Guo Xiaogang, chief physician of the Department of Cardiology of the First Hospital of Zhejiang University, said, "Especially when the emotions are under greater pressure, extreme fatigue, pain, panic, or in a crowded, stuffy room is more likely to have a seizure." ”
At present, the cause of the disease is unknown, most common in school-age children, adolescents, girls more than boys, usually manifested as standing or sitting up when suddenly syncope, before the onset of the disease can have a brief dizziness, inattention, rapid heartbeat, pale face, vision, hearing decline, nausea, vomiting, sweating, standing instability and other aura symptoms, severe cases can have 10-20 seconds aura.
In addition to Tingting, recently, the team of cardiology experts of the First Hospital of Zhejiang University has also successively received a number of patients who have not been able to find a reason for seeing a doctor for many years, and have finally been diagnosed with vasovagal syncope. There is a 19-year-old Hangzhou girl who is attending college in Nanjing, who once had a sudden seizure while walking on the road, hit the railing on the side of the road, causing serious head trauma; and a 52-year-old aunt, who has often fainted since elementary school, but has not been diagnosed for many years and has never dared to go out alone. At present, these patients have received atrial vagus ganglion plexus catheter ablation, and the treatment effect is found to be better in follow-up.
Experts from the First Hospital of Zhejiang University remind that if syncope of unknown cause occurs, it is especially prone to seizures in a stressful, fatigue, crowded, and sweltering environment, especially in younger patients, who have not yet identified the cause after multiple screenings, and should be vigilant that it may be vasovagal syncope. Although the disease is not directly life-threatening, because syncope often occurs, it is very easy to cause accidental injury, and it is necessary to screen and intervene early.