Neurocardiogenic Syncope

Stephen E. Piwinski, Stefan Osswald, Thomas G. Trouton, Brian A. Mcgovern

Research output: Contribution to journalLetterpeer-review

1 Scopus citations


To the Editor: The Images in Clinical Medicine in the July 1 issue1 intrigued me. I am uncertain whether the hemodynamic reaction shown represents syncope mediated by the neurocardiogenic (Bezold-Jarisch) reflex or carotid-sinus hypersensitivity with only a vasodepressor component. Generally, bradycardia is expected in neurocardiogenic syncope, which is thought to be mediated by vagal afferent and efferent fibers2,3. Conversely, carotid-sinus hypersensitivity mediated by glossopharyngeal afferent fibers occurs without bradycardia in a pure vasodepressor reaction4. Given the patient's history of metastatic cancer of the neck, carotid-sinus hypersensitivity seems to be a strong candidate for having produced the illustrated…

Original languageEnglish (US)
Pages (from-to)1966-1967
Number of pages2
JournalNew England Journal of Medicine
Issue number26
StatePublished - Dec 23 1993
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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