Micturition Syncope: A Case Study

The tilt table test regenerate the patient’s symptoms, thus resulting in a positive test. As previously mentioned the patient’s symptoms occurs after passing urine in the morning and is known as micturition syncope. This micturition syncope is thought to have a relationship with vasovagal syncope. As the patient has vasovagal episodes and in relation to micturition syncope, the patient will not prescribe alpha-blockers for his prostatic urinary symptoms. Alpha-blockers are also used to reduce blood pressures and a side effect of dizziness can result being on this medication (Bott and Kirby 2007).

In relation to previous investigations, the sinus bradycardia ECG has significance as there is a relationship between vasovagal syncope and sinus

Alcohol causes an impairment on the vasoconstriction of the blood vessels resulting in hypotension and/or syncope. The patient could also use compression stockings to improve the blood flow thus reducing venous pooling.

To reduce venous pooling, the patient could also do exercises known as PCMs like flexing hands or feet as this promotes the blood flowing. A clinical trial of patients with at least 100-200 episodes has shown that patients who use conventional therapy with PCMs have 76 syncope episodes to the patients on the conventional therapy have 142 episodes. Therefore, patients on the conventional therapy and PCMs are have reduced compared to conventional therapy alone (van Dijk et al 2006).

Medication can be prescribed for a patient with vasovagal syncope. The patient could take Fludrocortisone (mineralocorticoid) tablet results in the retention of water and sodium and exertion of potassium thus increasing blood volume. However a double randomised placebo-controlled test has shown to the patients on the Fludrocortisone have been more symptomatic than the placebo group (Kuriachan et al