運動負荷と採血時に血管迷走神経反射が誘発されためまい症例

概要

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The vasovagal reflex (VVR) is a reflex reaction in which abnormal autonomic system activity may be involved, and it has been known as a cause of dizziness and syncope following standing up quickly, drawing blood and after exercise. We report on a case where an exercise test was used to clinically confirm dizziness due to the VVR. A 17-year-old-male visited the clinic complained of recurring dizziness during exercise. He underwent brain computed tomography, ECG, and master ECG at another hospital. The VVR was caused when drawing blood. The head up tilt test was performed, but the test was negative. Thus, an exercise test was performed to confirm the diagnosis. The subject steps up and down on a stair until he complain of sensations such as dizziness nausea and syncope. Heart rate and blood pressure are checked every 5 minutes during exercise and before and after the exercise test. The exercise test was negative. But the VVR attack recurred together with bradycardia (36 beats/min) 4.5 minutes after the test. A diagnosis of the post-exertional syncope type of vasovagal reflex was made.