Vaso-Vagal Syncope?

[mark99]

Ever since I read this thread in the "Accidents and Incidents" forum - http://www.scubaboard.com/showthread.php?t=145976 I've been thinking how much this sounds like a simple vasovagal reaction, and I thought I'd post here for comment. Several factors seem to be at play here- dieting and out late the night before drinking EtOH contributing to possible dehydration, the use of the Scopolomine patch, positional change (diving to getting out of the boat = laying down to standing) and sudden stress/exercise (concern about ability to find/get out of the boat, combined with the physical activity of reaching and getting out). Particularly I wonder if Scopolomine acting as a vasolytic could reset the resting vagal tone, and when it wears off (or is washed off during the first dive) could result in increased vagal effects. Do you think the combination of a little dehydration, Scop patch removal, positional change (horizontal to vertical) and stress/exercise could result in a vasovagal syncope?

 

[TSandM]

I don't think you can reset the resting vagal tone that quickly.

From reading the account, it sounds as though he was still in the water, handing up fins, so the gravitational effects of the transition from water to land would not have kicked in yet. Further, he was out, and reportedly deteriorating, for over five minutes after being removed from the water. Vasovagal syncope is brief, and often resolves simply with a horizontal position.

My reading of the account doesn't suggest either orthostatic hypotension or vasovagal syncope. Another arrhythmia, perhaps, though.