?? Summer Heat and Vasovagal Syncope: Stay Hydrated to Stay Safe ???
Vasovagal (neurocardiogenic) syncope is a common cause of fainting, especially prevalent in the summer. Warm weather, sweating, and inadequate hydration can trigger these episodes. Common scenarios include standing for long periods, prolonged sitting during travel, or inadequate fluid intake.
In our busy lives, we often overlook hydration, substituting water with caffeinated or alcoholic beverages. These diuretics can dehydrate us further, leading to what I call “running on an empty tank.” This is particularly risky for the elderly.
When dehydrated, prolonged standing or sitting can cause blood to pool in our legs, reducing central blood volume. A large meal can divert blood to the gut, and age-related vascular changes or blood pressure medications can further contribute to this problem, setting up a perfect storm for vasovagal syncope.
The body's response to low blood volume is to contract leg muscles, increasing heart rate and muscle stiffness. This can choke off the blood supply to the heart muscle, triggering a protective reflex that slows the heart and dilates blood vessels, leading to a sudden drop in blood pressure and fainting.
Patients often feel hot, sweaty, and nauseous before fainting. The best prevention is proper hydration: at least two liters of non-caffeinated, non-alcoholic beverages daily, reducing caffeine and alcohol intake. Some may also need to increase salt intake to retain water.
A tell-tale sign of vasovagal syncope on ECG is fast heartbeat followed by a sudden slowing of our natural pacemaker – the sinus node – and/or the conduction system with an ensuing pause or simply a sudden drop in heart rate. This drop may be sufficient to cause the faint but is tough to diagnose. Common consumer wearables like Apple watches and Kardia devices are great at recording the rhythm of the heart in awake patients able to use the device. Holter monitors that are worn for one or more days are great at recording this arrhythmia so long as you faint while wearing them. To date, the best alternative has been implantable loop monitoring devices which, although very effective with a battery life of several years, are expensive and require an invasive procedure. Novel textile computing devices like Myant Skiin shine here.
As a cardiologist, I frequently see patients with vasovagal syncope. On-call for cardiology this weekend, I saw four such patients, all victims of poor hydration practices combined with the hot weather. One happened to be wearing the Skiin monitor. These devices record a three-lead medical-grade ECG along with a slew of other parameters. The full-disclosure ECG is stored in the cloud for 6 months.
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It was such a relief for the patient and her family to see the ECG tracing showing the typical pattern of the heart speeding up to over 100 beats per minute and then suddenly slowing down to 50 beats per minute before reaccelerating a few minutes later – long enough for her to lose consciousness and fall. She has been having multiple such episodes over a few months!
Using Skiin we could identify her syncope pattern, providing her with much-needed answers and prevention strategies.
Stay hydrated, and stay safe this summer! ??
Before significantly changing your hydration practices, please ask your doctor if this is safe for you and if you have these symptoms and are looking for answers, consider using Skiin
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Experimental Medicine , Faculty of Medicine, UBC, Vancouver | Medical Content Writing
4 个月"Have you found any effective hydration strategies to prevent fainting? How does dehydration affect your daily productivity?" https://lnkd.in/gsaeuFhu