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Fibromyalgia associated with vasovagal syncope in women
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Fibromyalgia was relatively frequent among women with vasovagal syncope, according to recent study results.
Researchers studied 50 patients (median age, 21 years; 68% women) with vasovagal syncope, an acute manifestation of autonomic nervous system dysfunction, seen at the National Cardiology Institute of Mexico between June 2009 and June 2012. The patients completed the Composite Autonomic Symptoms and Signs questionnaire and the Fibromyalgia Impact Questionnaire, and underwent a head-up tilt test. Patients were examined by a rheumatologist to confirm fibromyalgia (FM).
Eight patients (16%) with vasovagal syncope, all women, had concomitant FM (P=.034 by Fisher test). The fibromyalgia patients tended to have more sphygmomanometry-evoked allodynia (P=.07). The vasovagal syncope patients with FM had more secretomotor symptoms, including dry eyes and dry mouth, and bowel constipation compared with patients with vasovagal syncope only. Age of the FM subgroup patients correlated with disability, insomnia and pupillomotor impairment, while blood pressure was negatively correlated with the number of syncope episodes, constipation, insomnia, disability and pupillomotor impairment. In the subgroup of fainters without FM, no intragroup correlations were found.
“The prevalence of FM in this group of people with vasovagal syncope is higher than expected for the general population,” the researchers reported. “According to several epidemiological studies, up to 4.7% of the general population has FM. … In the present study, 16% of persons with vasovagal syncope had FM.”
The findings of FM prevalence derived from a study of a specialty referral group “and may not be the actual incidence in other practice settings,” the researchers said.
“It seems important to search for dysautonomic comorbidities in patients with vasovagal syncope and/or fibromyalgia, to provide a patient-centered holistic approach, instead of the often currently used therapeutic partition,” the researchers concluded.
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