A CASE OF VASOVAGAL SYNCOPE WITH CONVULSIONS : The Effects of Midodrine Hydrochloride

SEN KOYAMA; TAKU MATSUBARA; YOSHIFUSA AIZAWA; MITSURU OHSHIMA; TOSHIO YAMAGUCHI; YUKO YAMAZAKI; YUTAKA IGARASHI; YUSUKE TAMURA; MASARU YAMAZOE; TOHRU IZUMI; AKIRA SHIBATA; YASUKI TANAKA; KENICHI WATANABE

doi:10.1253/jcj.56.950

SEN KOYAMA, TAKU MATSUBARA, YOSHIFUSA AIZAWA, MITSURU OHSHIMA, TOSHIO YAMAGUCHI, YUKO YAMAZAKI, YUTAKA IGARASHI, YUSUKE TAMURA, MASARU YAMAZOE, TOHRU IZUMI, AKIRA SHIBATA, YASUKI TANAKA, KENICHI WATANABE

Author information

SEN KOYAMA
TAKU MATSUBARA
YOSHIFUSA AIZAWA
MITSURU OHSHIMA
TOSHIO YAMAGUCHI
YUKO YAMAZAKI
YUTAKA IGARASHI
YUSUKE TAMURA
MASARU YAMAZOE
TOHRU IZUMI
AKIRA SHIBATA
YASUKI TANAKA
KENICHI WATANABE
Author's Organization：
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
The First Department of Internal Medicine, Niigata University School of Medicine
Nanbugoh Hospital
Tsubame Rosai Hospital

Keywords: Vasovagal syncope, Head-up tilt test, Midodrine hydrochloride, Alpha-1 stimulant, Capacitance vessels

JOURNAL FREE ACCESS

1992 Volume 56 Issue 9 Pages 950-954

DOI https://doi.org/10.1253/jcj.56.950

Details

Abstract

A 42-year-old female had suffered from repeated syncope. She had vasovagal syncope with convulsions from vasodilatation and cardiac standstill which lasted for 9.8 sec. The 60 ° head-up tilt test, nitroglycerin injection and isoproterenol infusion provoked vasovagal reaction. Although a beta blocker was not effective in preventing tilt-induced hypotension and bradycardia, midodrine hydrochloride (alpha-1 stimulant) or atropine prevented it. In this patient, insufficient constriction of capacitance vessels might have played an important role in activation of an inhibitory reflex from cardiopulmonary mechanoreceptors which caused hypotension and bradycardia.

Corresponding author

Register with J-STAGE for free!