A multitude of nonpharmacological interventions to terminate hiccup belong to the public-domain hiccup "mythology" or have been described in the medical literature as case reports. While usually effective in terminating bouts of acute hiccup, they are mostly ineffective in cases of hiccupping that have been present for an extended period. The common denominator of most of these therapeutic maneuvers some also used to terminate paroxysmal supraventricular tachycardia is their ability to directly or indirectly increase efferent vagal activity. This short report provides an overview on hiccups and attempts to identify the lesser known personalities who pioneered its treatment by vagal maneuvers. The recent introduction of electrical vagus nerve stimulation for therapy-resistant hiccup is the ultimate compliment to these pioneers.

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Medwave se preocupa por su privacidad y la seguridad de sus datos personales. Palabras clave: syncope, neurally mediated faints, tilt table test, postural orthostatic intolerance, electrocardiogram, cardiac event monitor. Tabla 1. Figura 1. Se reconocen cuatro tipos de respuesta a la prueba de mesa basculante o prueba de mesa inclinada tilt test :. Figura 2. Patrones de respuesta durante la prueba de mesa basculante. Figura 3. Respuesta vasovagal mixta durante la prueba de mesa basculante.

Figura 4. Respuesta vasovagal cardioinhibitoria durante la prueba de mesa basculante. En total se incluyeron 57 pacientes en el grupo marcapasos y 54 pacientes en el grupo control. Figura 5. Maniobra de Valsalva La maniobra de Valsalva se utiliza para evaluar la integridad de los arcos reflejos arteriales y cardiopulmonares. Figura 6. Maniobra de Valsalva. La prueba se considera positiva si se produce un incremento mayor de 20 latidos por minuto en ritmo sinusal con una dosis menor de 0,5 mg.

Fase 1: bradicardia sinusal progresiva. Fase 2: bloqueo AV de primero y segundo grado. Fase 5: taquicardia sinusal refleja Figura 7. Figura 7. Prueba de adenosina. La prueba se considera positiva cuando la fase tres es mayor a 10 segundos considerando posibles escapes ventriculares y es negativa cuando no existe fase 3 o la misma es menor a 10 segundos.

Sin embargo, existe una constante controversia en cuanto al valor de la adenosina para identificar pacientes candidatos al implante de marcapasos. Figura 8. Figura 9. Figura Bradicardia sinusal y paro sinusal en Holter 24 horas.

Aumento del voltaje de la onda R en derivaciones antero laterales. Derivaciones del plano frontal. Syncope represents one of the most frequent reasons for consultation in the emergency department. A proper identification will allow a precise etiologic approach and the optimization of delivery of health resources.

Once knowing the classification of syncope; it is the clinical interrogatory what enables to discriminate which of these patients present with a neurogenic mediated syncope or a cardiac mediated syncope. The use of diagnostic methods such as the tilt test, will clarify what type of neurally mediated syncope predominates in the patient. The electrocardiogram is the cornerstone in the identification of those patients who had a true episode of self-limited or aborted sudden death as the first manifestation of their syncope, a fact which provides prognostic and therapeutic information that will impact the morbidity and mortality.

Syncope: electrocardiogram and autonomic function tests. Medwave ;16 Suppl 4 :e doi: Ficha PubMed. Contacto English Email: Clave:. Neurol Clin. Clinical practice. Neurocardiogenic syncope.

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Ann Intern Med. A randomized trial of permanent cardiac pacing for the prevention of vasovagal syncope. A randomized, double-blind, placebo-controlled study of permanent cardiac pacing for the treatment of recurrent tilt-induced vasovagal syncope. Dual-chamber pacing in the treatment of neurally mediated tilt-positive cardioinhibitory syncope : pacemaker versus no therapy: a multicenter randomized study.

Mechanism of 'inappropriate' sinus tachycardia. Role of sympathovagal balance. Basic autonomic test. O'Mahony D. Pathophysiology of carotid sinus hypersensitivity in elderly patients. Carotid sinus syndrome--clinical characteristics in elderly patients.

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The management of patients with carotid sinus syndrome: is pacing the answer? PubMed Low PA. Laboratory evaluation of autonomic function. En: Clinical autonomic disorders: Evaluation and Management; Vasovagal susceptibility to nitrate or isoproterenol head-up tilt. Am J Cardiol. The normal range and determinants of the intrinsic heart rate in man.

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Maniobra De Valsalva

Jump to navigation. Supraventricular tachycardia SVT is a common heart abnormality that presents as a fast heart rate. This heart rhythm disturbance can occur in healthy individuals and may include such symptoms as chest pain, palpitations, shortness of breath, sweating, and feeling faint. In rarer instances, unconsciousness may occur.


Treatment of Hiccup by Vagal Maneuvers



Treatment of Hiccup by Vagal Maneuvers



Maniobra De Valsalva


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