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Can An Aortic Aneurysm Cause Vasovagal Synscope?

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Posted on Mon, 28 Apr 2014
Question: All my life I have suffered periodic bouts of fainting, sometimes accompanied by seizures as a child. As an adult I have fainted several times in the last two years, though no seizure convulsions. I'm not sure if anxiety has caused the vasovagal synoscope or the synoscope has caused the anxiety. Likely a vicious circle has emerged. EEG with flashing lights is fine. ECG is fine. CT scans done as a child revealed nothing. Recently had an MRI last week, result not fine. Last week I had an MRI with angiogram scan revealing a 1.8mm left carotid anuersym above the bifurcation, in the middle of the length from bifurcation running into the cranial area. I understand the risk of rupture is excessively low at this point, about 0.05%, though risk management is required such as b/p medication, diet, exercise, weight loss, etc. The brain is totally normal. I do regular exercise 3x a week, a mix of cardiovascular and resistance training. My blood pressure is in the normal range, though tends to be borderline when measured at a hospital. I recently gained about 30 pounds very quickly after the birth of my child which I'm trying to work off now. I'm definitely not in my target BMI, and overweight so there is some work to do there. I smoked from the ages of 18 to 32. I quit when I was 32 and am now 34. Questions: -What kind of possibilities exist for the left corotid anuerysm to be causing vasovagal synoscope - what is the specific anatomical relationship between the left corotid above the bifurcation and the vagus nerve, could the aneurysm be stimulating the vagus nerve, other reasons for a connection between the aneurysm and synoscope? I will show you the film. -As I understand it, excluding stress or other psychosomatic indications, vasogal synoscope may be caused by other underlying cardiac issues. A. Can an aortic aneurysm cause vasovagal synscope? (though the incident of multiple anuerysms in the general population is low as I undersatnd it 3-6% of people have anuerysms, of that 10-15% have multiple anuerysms). B. What other underlying cardiac issues may be present (undetected by ECG) and contributing to vasovagal synoscope. C.What other diagnostic tests do you think may be warranted to investigate cardiac health?
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Answered by Dr. Benard Shehu (4 hours later)
Brief Answer: Following answers to your queries.... Detailed Answer: Hi, I have gone through your MRI reports and I have noticed that the aneurism is small in size and located in the Circulus of Willis. Please bare in mind that circulus of Willis is superficially located as compared to vagal ganglions that are deeper. A. Yes, an aortic aneurysm can cause vasovagal syncope. In your case, the aneurism is located far distant from vagal plexus. B. There are a variety of cardiac problems that are associated with vaso-vagal syncope including valvular diseases (aortic stenosis) and rhythm disorders (ventricular arrhythmia, ventricular tachycardia, etc.). Valvular diseases can be detected by routine EKG while arrhythmia problems are detected by Holter monitoring and not by routine EKG. C. There are 5 main causes to syncope: 1. vagal 2. Cardiac 3. Metabolic 4. Neurological 5. Psychological The vagal cause can be determined by the TILT test and carotid massage test. If during these tests, the symptoms will be present, then, vagal syncope is diagnosed. Cardiac issues are determined by ultrasound and holter monitoring as mentioned earlier. Metabolic problems are determined through blood tests (blood glucose level, etc.). The neurological evaluation will exclude neurological syncope. If everything is ok, then. syncope is related to stress or other psychological problems. Hope it answered to your queries! Let me know if you need further assistance! Dr.Benard
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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Can An Aortic Aneurysm Cause Vasovagal Synscope?

Brief Answer: Following answers to your queries.... Detailed Answer: Hi, I have gone through your MRI reports and I have noticed that the aneurism is small in size and located in the Circulus of Willis. Please bare in mind that circulus of Willis is superficially located as compared to vagal ganglions that are deeper. A. Yes, an aortic aneurysm can cause vasovagal syncope. In your case, the aneurism is located far distant from vagal plexus. B. There are a variety of cardiac problems that are associated with vaso-vagal syncope including valvular diseases (aortic stenosis) and rhythm disorders (ventricular arrhythmia, ventricular tachycardia, etc.). Valvular diseases can be detected by routine EKG while arrhythmia problems are detected by Holter monitoring and not by routine EKG. C. There are 5 main causes to syncope: 1. vagal 2. Cardiac 3. Metabolic 4. Neurological 5. Psychological The vagal cause can be determined by the TILT test and carotid massage test. If during these tests, the symptoms will be present, then, vagal syncope is diagnosed. Cardiac issues are determined by ultrasound and holter monitoring as mentioned earlier. Metabolic problems are determined through blood tests (blood glucose level, etc.). The neurological evaluation will exclude neurological syncope. If everything is ok, then. syncope is related to stress or other psychological problems. Hope it answered to your queries! Let me know if you need further assistance! Dr.Benard