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Micruration syncope
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MICTURITION SYNCOPE Definition Micturition syncope also called Post Micturition Syncope. This condition occurs mostly in elderly males (usually over 49 years or more.) The events often occur at night during or immediately after urination after awakening from sleep (ie., while standing immediately after being recumbent for some time.) Causes: The situation that triggers this reaction are very diverse: When one strains to increase the flow of urine it stimulates the Vagal Nerve (usually more pronounced in elderly men with large prostrates) the vagal nerve stimulus causes slowing down of the heart (bradycardia) and severe drop in blood pressure. The heart cannot perform as a pump effectively if insufficient blood comes to it. The reaction can also be due to emotional stress caused by fear or pain People often become pale, nauseated, sweaty and weak before they lose consciousness Sometimes even defecating, coughing or swallowing can cause this syncopial attack Clinical Signs & Symptoms • Slow pulse • Slow heart rate (bradycardia) • Low Blood pressure • Drop Attacks • Vertigo • Acutely ill patients - blurred vision • Dimming Vision / Acute Slow pulse < 60 beats per minute, slow heart rate (bradycardia) - ECG taken at the time of syncopial attack shows wide curves and irregular beats (sinus bradycardia) Low Blood Pressure < 90 / 60 mm/Hg Drop Attacks - sudden loss of control, falling forward, yawning, and confusion Vertigo - sudden giddiness Acutely ill patients - following attacks of typhoid, jaundice, Blurred Vision / dimming of Vision: due to circulatory problems --Dr.PrabhuMD (talk) 13:47, 28 November 2008 (UTC) 
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