CURRENT ACHIEVEMENTS IN THE PATHOPHYSIOLOGY MECHANISMS UNDERSTANDING OF SYNCOPE DEVELOPMENT IN CHILDREN

Authors

DOI:

https://doi.org/10.11603/24116-4944.2023.1.13934

Keywords:

vasovagal syncope, syncope due to orthostatic hypotension, cardiogenic syncope, etiology, pathophysiological mechanisms, children

Abstract

The aim of the study – to analyze modern scientific achievements in the field of pathophysiological mechanisms of the syncope development.

Materials and Methods. PubMed Medline and Scopus databases were used to search for scientific studies using the search terms "syncope" and "etiology"; "syncope" and "pathophysiology"; "syncope" and "mechanisms of development". 76 full-text English articles published between January 2013 and December 2022 were included in this literature review.

Results and Discussion. Although the reasons for hemodynamic differences between patients with syncope and the general population remain unknown, probable mechanisms of noncardiogenic syncope development in the form of a decrease in the blood circulating volume, an increase in venous filling, and abnormal neuroendocrine activation have been described. The current scientific understanding of the role of the pathological Bezold-Jarisch reflex in the development of syncope is considered. Attention is drawn to new concepts – “hypotensive phenotype”, which indicates susceptibility to the development of vasovagal syncope and "susceptibility to hypotension " in the context of the response to the tilt test. The mechanisms of the formation of vasodepression and cardioinhibition during passive orthostasis and their role in the pathogenesis of syncope are described. Evidence is presented for a wide range of neurohumoral changes associated with the development of syncope. A separate role is assigned to paradoxical peripheral vasodilatation, which can initiate inappropriate arterial hypotension during syncope. A number of facts are described, which are proof of the genetic basis of the fainting development. The further research is needed for a better understanding of all possible pathogenetic mechanisms of syncope, which will allow to improve the effectiveness of treatment and prevention measures, taking into account the pathophysiological features of each individual type of fainting.

Conclusions. The results of the literature review provide grounds for asserting that many factors, such as the abnormal Bezold-Jarisch reflex, dysfunction of the autonomic nervous system, neurohumoral factors, etc., to some extent explain the mechanisms of syncope development and leave a window of opportunity in the search for new effective methods of treatment and prevention of syncope in children.

Author Biography

T. A. Kovalchuk, I. Horbachevsky Ternopil National Medical University

кандидат медичних наук, доцент кафедри педіатрії № 2, Тернопільський національний медичний університет імені І.Я. Горбачевського Міністерства охорони здоров’я України

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Published

2023-07-04

How to Cite

Kovalchuk, T. A. (2023). CURRENT ACHIEVEMENTS IN THE PATHOPHYSIOLOGY MECHANISMS UNDERSTANDING OF SYNCOPE DEVELOPMENT IN CHILDREN. Actual Problems of Pediatrics, Obstetrics and Gynecology, (1), 4–15. https://doi.org/10.11603/24116-4944.2023.1.13934

Issue

Section

PEDIATRICS