Increased vagal tone

Introduction The sympathetic and vagal tone are constantly changing to better regulate cardiovascular physiology. In general, increased vagal tone is not a morbid problem. The vagus nerve is the 10th pair of cranial nerves. It is the longest and most widely distributed pair of cranial nerves, containing sensory, motor and parasympathetic nerve fibers. The vagus nerve dominates breathing and digests most of the organs of the two systems, such as the heart's sensory, motor, and glandular secretion. Therefore, vagal nerve injury can cause dysfunction of circulation, digestion and respiratory system.

Cause

The vagus nerve is an autonomic nerve in our body. It is the autonomic nerve of the human body. It is not regulated by the individual. For example, fatigue, poor sleep, etc. can all have symptoms of vagus nerve hyperactivity. The vagus nerve belongs to the parasympathetic nerve, and the tension increases and the heart rate slows down.

There are several factors that cause sinus block:

(1) Heart disease itself: acute myocarditis, myocardial infarction, cardiomyopathy, sick sinus syndrome, etc.

(2) increased vagal tone and carotid sinus allergy: sinus block caused by increased vagal tone is mostly temporary or sporadic sinus block.

(3) Effects of certain drugs: digitalis poisoning, quinidine poisoning, and hyperkalemia.

an examination

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Abnormal vagal nerve involvement: nausea can cause vagus nerve excitation, vagus nerve excitation can delay the conduction of atrioventricular node, normal ECG shows 1 degree atrioventricular block, when the vagus nerve is excited, it can cause 3 degree atrioventricular block, and This is the specific reason why the limbs are cold, the heartbeat is slow, and then accompanied by a short period of loss of consciousness.

Because the surface electrocardiogram does not show sinus node electrical activity, the diagnosis of first sinus block is not established. The third degree of sinus conduction block is difficult to distinguish from sinus arrest, especially when sinus arrhythmia occurs. The second degree of sinus conduction block is divided into two types: Mohs type I, ie, Wen's block, which shows that the PP interval is progressively shortened until a long PP interval occurs, which is shorter than the basic PP interval. Two times, this type of sinus block should be differentiated from sinus arrhythmia; when Mohs type II block, the long PP interval is an integral multiple of the basic PP interval. The sinus conduction resistance lag can occur with escape or escape rhythm.

Differential diagnosis

Vasovagal syncope: syncope refers to a brief loss of consciousness in a sudden episode, accompanied by a decrease or disappearance of muscle tone, which lasts for a few seconds to a few minutes, and is essentially a temporary reduction in cerebral blood flow. Syncope can be caused by cardiovascular diseases, nervous system diseases and metabolic diseases. However, many patients cannot find the cause based on medical history, physical examination, and auxiliary examination. They have long been called "unexplained syncope." With the development of medical technology, vasovagal syncope (VS) is the most common cause of unexplained syncope in children. According to incomplete statistics, about 80% of syncope belongs to this category.

Vagus nerve excitement: The vagus nerve is the 10th pair of cranial nerves. It is the longest and most widely distributed pair of cranial nerves, containing sensory, motor and parasympathetic nerve fibers. The vagus nerve dominates breathing and digests most of the organs of the two systems, such as the heart's sensory, motor, and glandular secretion. Therefore, vagal nerve damage can confuse circulatory, digestive, and respiratory dysfunction. Symptoms manifested as headache, dizziness, enlarged eyelids, blurred vision, dilated pupils, rapid heartbeat and even arrhythmia, cold and cold limbs, dyspnea and other sympathetic excitement or dizziness, drooping eyelids, tears Symptoms of sympathetic inhibition (ie, vagus nerve excitation) such as nasal congestion and bradycardia.

Symptoms of nerve root stimulation: lumbar disc herniation can occur congestion, edema, degeneration, showing signs of nerve root irritation. Lumbar disc herniation is a diagnosis of Western medicine, and Chinese medicine does not have this disease name. Instead, the disease is attributed to the category of low back pain and low back pain. This disease is one of the more common lumbar diseases in the clinic, and it is a common and frequently-occurring disease in orthopedics. Mainly because the lumbar intervertebral disc parts (nucleus pulposus, annulus fibrosus and cartilage plate), especially the nucleus pulposus, have different degrees of degenerative changes, under the action of external factors, the annulus fibrosus ruptures, nucleus pulposus tissue rupture Prominent (or prolapsed) in the posterior or spinal canal, causing adjacent tissues, such as spinal nerve roots, spinal cord, etc. to be stimulated or oppressed, resulting in lumbar pain, numbness, pain and other clinical symptoms of one lower limb or both lower extremities .

Abnormal vagal nerve involvement: nausea can cause vagus nerve excitation, vagus nerve excitation can delay the conduction of atrioventricular node, normal ECG shows 1 degree atrioventricular block, when the vagus nerve is excited, it can cause 3 degree atrioventricular block, and This is the specific reason for the coldness of the limbs, the slow heartbeat, and then the loss of consciousness for a short period of time. Because the surface electrocardiogram can not show the sinus node electrical activity, it is impossible to establish the diagnosis of the first sinus block. The third degree of sinus conduction block is difficult to distinguish from sinus arrest, especially when sinus arrhythmia occurs. The second degree of sinus conduction block is divided into two types: Mohs type I, ie, Wen's block, which shows that the PP interval is progressively shortened until a long PP interval occurs, which is shorter than the basic PP interval. Two times, this type of sinus block should be differentiated from sinus arrhythmia; when Mohs type II block, the long PP interval is an integral multiple of the basic PP interval. The sinus conduction resistance lag can occur with escape or escape rhythm.

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