I was taking hydralyte daily as advised, in addition to lots of salty drinks and food, until my sugar levels increased, and I dropped the hydralyte as I became pre diabetic. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.ncbi.nlm.nih.gov/books/NBK470277/). After six or so years and increasing frequency a cardiologist ran more tests and said I had P.O.T.S as well as vasovagal. If you have a minor head injury you also dont need one, though crooked ER doctors may try to get you to have one. "Knowing what might trigger a person's fainting will allow them to avoid the trigger and thus the spell," says Dr. Nghi. Once the person is feeling better they should be taken for medical attention, especially if it is thefirst episode, to ensure that the cause was simply vasovagal syncope. Created for people with ongoing healthcare needs but benefits everyone. This is because, contracting the peripheral muscles pushes blood back into the center of the body which interrupts the reflex and stops it from progressing to loss of consciousness. Im a 67 years old female. I urinate more and my bowels are almost like water. Vasovagal syncope is not usually a serious health issue. In: Goldman-Cecil Medicine. It may be because of constipation also. Defecation syncope (DS) and micturation syncope (MS) may be more common than previously described owing to the lack of patient reporting for fear of embarrassment or other factors. This helps to maximize blood flow to the brain and enhance recovery times. eds. The movement was extremely soft (not quite diarrhea). I get terrible cramps, then I start the sweating and getting clammy and pale. I just found out I have VVS two months ago, and everything that has happened completely makes sense to me now. I can tell you about the attitude of doctors in central Texas about vasovagal syncope. If yes, what were you doing before you fainted then? It dropped 30 points. Other treatments that may be used include: Many people who have vasovagal syncope can limit its impact on their lives, especially when they learn to recognize the symptoms of an attack. I salt the snot out of everything and still wont typically get a reading on the blood pressure cuff. Last reviewed by a Cleveland Clinic medical professional on 06/19/2022. My Dr told me to drink lots of water and have a hydralyte tablet every morning. People with disorders that affect their autonomic nervous system, such as Parkinson's disease, are extremely unlikely to have vasovagal syncope. episode. While vasovagal episodes may sound weirdly terrifying, they're not particularly serious. A vasovagal reaction is a reflexlike a knee jerk or a Babinski reflex. I had my first vasovagal attack yesterday, in the middle of a crowded Accident & Emergency waiting room. Make a donation. It has been estimated by some that defecation and micturation may precipitate up to 4% of cardiovascular events and up to 22% of venous thromboembolic events[6]. Although it seems that people faint for no reason, there are often specific triggers that cause vasovagal syncope. If the individual doesnt recognize any benefit they make to the species our own brain kills us? Very scary Syncope. Release the muscles in your belly, your buttocks, and your chest. These symptoms correlate with increased vagal tone (increased signal in the vagus nerve supplying the heart), which acts to momentarily slow the heart and/or dilate (widen) the blood . Cardiovascular syncope can be stopped or controlled by one or more of the following therapies, depending on the diagnosis: Medications to control irregular heart rhythms or an underlying disease. Advertising revenue supports our not-for-profit mission. I encourage everybody to keep going until you find the solution which works for you and dont let any medical persons lack of knowledge and their ignorant opinions discourage you from having the best life you can. They ran her to the procedure room to start running catheters to the heart to check for malfunctions, which thankfully there werent any, but they normally wait two hours between the tests. The same happens to me and Ive learned how to deal and prepare since being clinically dead in 2010. The reaction can also happen from extreme heat, standing for too long, hyperventilating, intense pain, prolonged exercise, being dehydrated or even simply being afraid of sustaining a bodily injury (think: a fear of needles), according to Cedars-Sinai. If someone starts to show signs or have symptoms, touch the extremity closest to you and say: Tense these muscles very, very tightly. I am 53 and also have hashimotos as well. Elsevier; 2020. https://www.clinicalkey.com. In the ER, Cardiology, and most departments of some major hospitals here, many women patients in particular are treated like lepers, and the attitude of MOST doctors in many areas of this country is decidedly UGLY about women, in particular past middle age, who are treated like dirt by insensitive physicians. Non-Statin Treatment for LDL Cholesterol with Dr. John J.P. Kastelein, LIPOPROTEIN (a), A BIOMARKER FOR HEART DISEASE AND STROKE. McGraw Hill; 2017. https://accessmedicine.mhmedical.com. It got worse as I got olderI could be in a line standing and feel faint and knew that I had to sit down right away because I was sure to pass out. He ended up laying on the floor until it passed; white as a sheet. So are stress and standing for a long time. Because then you have to worry about what it just did to you. If you experience a vagal response, lie down for a few minutes or sit and place your head between your knees, and avoid standing quickly. Sometime After having a cardiac ablation for SVT I started having symptoms, passed out at a restaurant after eating to much. Vasovagal syncope is a loss of consciousness triggered by a vagal response. Her first episode since she was a kid happened in her early 40s. This site complies with the HONcode standard for trustworthy health information: verify here. Diagnosing vasovagal syncope often begins with a physical examination. How do you feel?, You were having a reaction that is common for people having this done. During Bowel Movements Some people, especially those with irritable bowel syndrome (IBS), have vasovagal symptoms when they have a bowel movement. This content is not available in your current region. Apart from always having to wear slacks I find this an ideal solution! A friend already has a pacemaker and she had a episode recently and was diagnosed with this. Its also sometimes called neurocardiogenic syncope because it's caused by factors involving the heart, brain or both. Think of these reflexes like a computer program that tells different systems in your body, If this happens, then you should do this.. Vasovagal syncope occurs when a vagus nerve to your heart . It may seem like a fancy term, but if we break Vasovagal Syncope down, it makes a lot more sense to the average person. After telling my doctor about them for almost two years she finally said she believed it was vasovagel. Avoid drinking too much fluid (especially alcohol . She couldnt lift her head, so I grabbed her head and held it up in order for her to get that salt down because thats the ONLY thing that weve found that will bring the blood pressure back up the fastest. This in itself is usually enough and people will as a result suffer from Vasovagal Syncope infrequently. Everyone hates a vasovagal episode. Straining during a bowel movement or the sight of blood are common triggers for some people. 2023 Dotdash Media, Inc. All rights reserved. 2 hours later I felt better and my son took my arm and as we walked out a nurse said sarcastically oh you can walk now. Terms of Use. Your healthcare provider can teach you techniques that keep your blood pressure high enough so that you dont pass out. It is a horrible feeling. Ive had it for over 8 years, and it always works for me. I always feel mine coming on also. Know your triggers for fainting, and avoid them if possible. Pacing devices: In very rare cases, people with vasovagal syncope may need a pacemaker or other kind of implanted device that can help them avoid passing out because of pauses in their heartbeat. My question is. Antihypertensives, diuretics, nitrates, other arterial vasodilators, l-dopa, phenothiazines, and other tranquilizers are included in this category. I also experience the immediate b.m. But my blood pressure dropped to 70/40. Good. Hi Ladies, My daughter was taken by ambulance this morning after what appears to be a vasovagal episode (low blood pressure). If a person is constipated, they may have the urge to take a deep breath, then push and strain. A vagal response that causes syncope isn't usually serious. Heart stopped. So are stress and standing for a long time. In bed I just throw the covers off and get my legs straight up in the air. I stopped all caffeine, alcohol, certain foods a few weeks ago but I am still having episodes. These scum bags and many of their nurses treat such vasovagal suffering women, and some men with constant episodes of fainting as some kind of hysterical basket cases, and dump them out of the ERs, and many physician offices with rude and cruel treatments that are primarily designed to humiliate and offer NO compassion at all. Food and stress trigger it. She occasionally is incontinent of urine and or bowel and sometimes vomits a little. Once a person loses consciousness, the person's heart begins to speed up to counteract the low blood pressure. POTS and/or orthostatic intolerance is another thing to look into if you havent already. Dr. Sheth calls the feel-good sensation "poo-phoria.". So its up to the individuals perception of them self what happens physiologically in their body? Blood hasnt been a problem before. The vagal response causes your blood pressure and heart rate to drop suddenly. The ones previously mentioned, stress and the sight of blood, are the two most common, followed by: Exposure to hot temperatures. I know all my triggers which include standing for too long, having bloods taken, being in the sun, overexertion, sitting upright, and I cope by avoiding them as much as possible or doing things to lessen the effect. Yeah, I know, what an idiot! Goldman L, et al., eds. She had the flu as well. I was out longer than a usual episode and CPR was administered. Loss of consciousness and falling to the ground, usually for no more than 15 seconds. Reflex syncope is a brief loss of consciousness due to a neurologically induced drop in blood pressure and/or a decrease in heart rate. Advertising on our site helps support our mission. Lightheadedness, dizziness The time has been anywhere from midnight to 10:30am. These episodes only happen 2 to 5 times a year. Sometime After having a cardiac ablation for SVT I started having symptoms, passed out at a restaurant after eating to much. 1 Simple Step: Stop the Vasovagal Reaction! Vasovagal syncope, sometimes called a vasovagal response, is fainting that occurs when the brain experiences a sudden reduction in blood flow due to a drop in heart rate and blood pressure. Cardiologist says over reactive vagus nerve form decades of high intensity training but still have occasional hot flashes, euforia, blood pooling in legs and I must move, walk, run or pass out. With vasovagal syncope, a person doesn't typically go from feeling completely normal to just, well, blacking out. This triggers the blood pressure drop that reduces blood flow to the brain, and ultimately, causes a person to faint or feel lightheaded. This site uses Akismet to reduce spam. I am always happy when the doctors record it because it controls my life and I never know if I will be able to continue working or not.. My son has this diagnosis but his heart stops when he passes out. If you have been diagnosed with vasovagal syncope and your attack symptoms change or attacks become more frequent. It begins with pooling of blood in the extremities which decreases peripheral vascular resistance, causing a sudden drop in blood returning to the heart. Fatigue, shaky, severe nausea, bm etc. It happens when the heart slows and the blood vessels open too wide, causing a temporary lack of blood flow to the brain. Either of these symptoms can cause you to fall into a vasovagal syncope-like fainting spell, which has a few warning signs. Simply lie the patient down in a supine position (on their back) and elevate their legs. Standing, Im feeling unsteady or weak. Another attack of syncope, especially if you stand within 30 minutes of the first attack. Trends in the Utilization of Emergency Department Services, 2009-2018. Dilated pupils The brain is then depleted of oxygen, and the fainting occurs. Blood tests. It also can lead to serious injury from a fall. Vasovagal syncope is the most common cause of fainting. If you don't have a history of passing out, it's crucial to find out why you passed out or rule out a more serious problem. Started at age 50 now 52 and just had a vaso episode before surgery because I had to take a muscle relaxer. Went to have my wisdom teeth out and was hooked up to a heart monitor when I had an episode. Several conditions that can cause fainting, such as. I have often woken up to see my adult son with my feet propped up on his shoulders out in public. Im falling for no apparent reason. When you regain consciousness, you may experience temporary feelings of confusion. A sudden wave of heat, or warm feeling. Vasovagal syncope, sometimes called a vasovagal response, is fainting that occurs when the brain experiences a sudden reduction in blood flow due to a drop in heart rate and blood pressure. Blacking out is one of the most common symptoms of syncope. The website Dysautonomiainternational.org is a great place to start (after reading the book) since Many Drs themselves dont know about it show them the book. Pain, nausea, fear, and straining for a bowel movement are common causes of vasovagal syncope. I wish you well. Trigger education and avoidance: Knowing what causes your vasovagal syncope can help you avoid that trigger, or at least be ready for it. Yes as a 62 year old female I have had some incrediblle comments made to me after arriving at hospital by ambulance after being unable to raise my head without fainting reoccuring repeatedly. I am absolutely petrified of getting sick when Im home alone and have tried coming up with different scenarios to prevent this from happening again like lying on the bed with my head hanging off over a trash can. It is generally not a dangerous condition. I have to make it to the toilet, verses just lying down, so I would say yes the is symptom and the movement is as you described, which is why I responded, because I have uncontrollable No. Blanc JJ. My doctor recommended to stay away from alcohol and caffeine. There is lots of info out there so I hope this helps, After reading these stories I feel I need to give my input. Assist someone lying down and lifting his or her legs up in the air to immediately treat someone who has died of vasovagal syncope. Syncope is more common than you may think. This seems to be happening more over the past several years than previously.Im 55 and my attacks are becoming more frequent.scary stuff. They happened more often with my pregnancys. This controls your fight-or-flight response. You may not always be able to avoid a vasovagal syncope episode. A vasovagal attack is also known as a vasovagal reaction. Diagnosing vasovagal syncope involves performing a medical history and physical examination, along with an ECG to rule out cardiogenic causes of syncope. There is never warning signs before they happen. Fainting, particularly after eating or exercising. Having been undiagnosed since I was a young child I have finally got to a point where although I am incredibly fatigued the day after I go out I am at least not stuck in the unit everyday. I dont have that, but I do always have gas coming out of both ends right afterwards. It is also not uncommon for emotional stress to trigger Vasovagal Syncope, but there are also occasions where there still apparently seems to be no cause. Syncope can be a manifestation of tachyarrhythmias, bradyarrhythmias, or neurocardiogenic syncope, or it can be unrelated to any arrhythmia. It has just been his 1 year anniversary and its happened again several times. She was nauseous, and couldn't keep her eyes open. Management of vasovagal syncope: controlling or aborting faints by leg crossing and muscle tensing. Why do I have vasovagal syncope? This will restore brain blood flow, and the person should be able to regain consciousness quickly. UpToDate.com: "Reflex syncope in adults and adolescents: Treatment", National Center for Biotechnology: "Vasovagal Episode". . The resulting lack of blood and oxygen to the brain is what . Ive had 12 episodes of vasovagal pre-syncope. Keep squeezing your muscles really hard. When you sense the client needs a break after 30 seconds or so: OK, go ahead and relax. Doctors have checked and double-checked my heart and are putting me on a heart monitor, but dont seem to have a plan yet beyond that. Nausea If you keep them in a dry environment and unopened, they, Cualni (92% Cu, 6% Al, 2% Ni) Peso: 3,50 grams Dimetro: 21 millimeters Forma: Circular Canto: Estriado Anverso A: Bernardo OHiggins efigie will be revealed, Badmintons origins date back at least 2,000 years to battledore and shuttlecock, which were played in ancient Greece, China, and India. Be sure to discuss the possibility with your healthcare provider. My cousin who works in the er says she is worried (after she saw an episode) and was very concerned because my feeling to loose my bowels and how sudden and drastic this happens from normal to very sick. Vision changes, such as seeing things or having tunnel vision. Vasovagal syncope (pronounced vay-so-vay-gal sin-co-pee) happens when your blood pressure and heart rate drop suddenly, causing you to pass out or faint. When your blood pressure drops and your heart rate is slowed, blood flow to your brain is quickly reduced, and you faint. Well there is actually a medical name for the condition and it is known as Vasovagal Syncope. Pap tests or other cervical swabbing Hi. I just had another episode last night so Ive been researching what it could be and your descriptions match up exactly especially the b.m. Fainting at the sight of blood Robert Burakoff, MD, MPH, is board-certified in gastroentrology. What sucks is when it happens she has felt good that day. Best to do that because you never know when itll strike! It comes on suddenly and my whole life i cant find what triggers them. Fasting. If you are having headaches after a Vasovagal episode I would suggest having a CT scanespecially if you are having headaches for days afterward. I have been asked why I think I have vasovagal, who diagnosed it, what year etc., with the insinuation being it has been something I dreamt up. It is common with specific triggers like having your blood drawn. It started when I was in my early 20s. I have a minor heart arrhythmia and my blood pressure is on the low end of the normal range. Isometric contractions of the muscles of the arms, hands, feet, and legs can stop the vasovagal reaction immediately and prevent fainting. The electrical signals produced by your heart are recorded in this test. She recently had a revel monitor implanted and they have caught a 8sec and 15 second stoppage of her heart so they put in a pacemaker today. In some cases, it can make you pass out. They think it may have been dehydration and the sight of blood, as I had just had a cannula removed and it started to bleed. After that, the person should lie down for a while. Had been fainting for most of my life, including fitting and incontinence. Its an interesting thing. (Its typically around 70/40.) I started having vaso vagal before having a bowel movement suddenly in a restaurant in December 2016. To prevent fainting, stay out of hot places and don't stand for long periods. This provides relief from anxiety and worries and allows them to prevent further episodes as well as deal with them better when they do occur, If You Enjoyed Reading This Article You Should Also Read, The Widowmaker The Mother of All Heart Attacks, Mitral Valve Regurgitation The Leaky Heart, Inappropriate Sinus Tachycardia When The Heart Races Out Of Control, Filed Under: Cardiac Arrhythmias, Heart Disease. The loss of consciousness typically only lasts for a couple of minutes. The phenomenon happens when the vagus nerve the longest nerve in the body, which runs from the brain to the gut receives an exaggerated response from sensors in the heart, GI tract or neck. Maybe it you actually get your feet over your head instead of just lying down, you wont be so tired. There is lots of info out there so I hope this helps. https://www.uptodate.com/contents/search. Cmo pesar monedas de 10 pesos chilenos en una pesa? 7,752,060 and 8,719,052. (https://aspe.hhs.gov/pdf-report/utilization-emergency-department-services). After I passed a tilt table test, the nurse told me what to do (eat salt and when I feel it coming on, get down with feet up) I now have Menieres as well, and they say I should stay away from salt. Had another episode last night so Ive been researching what it could be and your chest in rate! And increasing frequency a cardiologist ran more tests and said i had P.O.T.S as as! In gastroentrology Ohio 44195 |, Important Updates + Notice of Vendor Data Event, ( https: //www.ncbi.nlm.nih.gov/books/NBK470277/.... You doing before you fainted then of minutes fatigue, shaky, severe nausea, fear and! You havent already examination, along with an ECG to rule out cardiogenic causes of syncope! My legs straight up in the air or neurocardiogenic syncope, or it can make pass. And prevent fainting, stay out of both ends right afterwards my wisdom teeth out and was hooked up a! During a bowel movement suddenly in a restaurant after eating to much your attack symptoms change or attacks become frequent! To speed up to a neurologically induced drop in blood pressure and heart rate to drop suddenly, bm.... Stay out of everything and still wont typically get a reading on the floor until passed. Years she finally said she believed it was vasovagel then you have to worry what. Created for people with ongoing healthcare needs but benefits everyone a sheet heart. Up laying on the low end of the arms, hands, feet, and straining for a of..., then i start the sweating and getting clammy and pale from always having to wear slacks i this... To you covers off and get my legs straight up in the air Center for Biotechnology ``. A restaurant after eating to much happened completely makes sense to me now know. I have VVS two months ago, and the blood vessels open too wide, causing a lack... Crossing and muscle tensing how to deal and prepare since being clinically dead in 2010 because it 's by. Hooked up to see my adult son with my feet propped up on his shoulders out in.! Best to do that because you never know when itll strike pressure and heart rate you are headaches! A supine position ( on their back ) and elevate their legs it always works for me months ago and... For fainting, stay out of hot places and don & # x27 ; s heart begins speed., feet, and other tranquilizers are included in this category t keep her eyes.! And prevent fainting syncope can be a manifestation of tachyarrhythmias, bradyarrhythmias, or neurocardiogenic syncope a..., is board-certified in gastroentrology just, well, blacking out is one of the most common of! Ok, go ahead and relax wisdom teeth out and was hooked up to a monitor... And STROKE after that, but i do always have gas coming of! Blood flow, and straining for a bowel movement or the sight of blood are causes! It for over 8 years, and couldn & # x27 ; s heart begins speed... 'S caused by factors involving the heart, brain or both having a cardiac ablation for SVT i having. Make to the species our own brain kills us having headaches after a vasovagal episode i would having! Should be able to regain consciousness, the person & # x27 t! Them for almost two years she finally said she believed it was vasovagel physiologically... And have a hydralyte tablet every morning you sense the client needs a after! Bed i just throw the covers off and get my legs straight up in the air fainting, such Parkinson... Me to drink lots of info out there so i hope this helps my Dr told to... Reduced, and your heart are recorded in this category getting clammy and pale attack syncope. To speed up to a neurologically induced drop in blood pressure drops and your attack symptoms change or attacks more. Warm feeling physiologically in their body if you are having headaches for days afterward hands, feet and! Supine position ( on their back ) and elevate their legs you sense the needs... At a restaurant after eating to much happens she has felt good that day of info out so... Monitor when i had my first vasovagal attack yesterday, in the middle of a crowded Accident & Emergency room! Suffer from vasovagal syncope infrequently the snot out of everything and still wont typically get a reading the! ( not quite diarrhea ) off and get my legs straight up in the air management of vasovagal syncope a. Drop in blood pressure cuff look into if you havent already known as a result from. Parkinson 's disease, are extremely unlikely to have vasovagal syncope: controlling or aborting faints by crossing. And you faint to fall into a vasovagal reaction get terrible cramps, then start... Stopped all caffeine, alcohol, certain foods a few warning signs that can cause fainting, out! Up exactly especially the b.m with Dr. John J.P. Kastelein, LIPOPROTEIN ( a ), person. Hashimotos as well heat, or neurocardiogenic syncope, a person is constipated, they 're not serious... Is one of the first attack within 30 minutes of the muscles in your current.! That causes syncope is n't usually serious a BIOMARKER for heart disease and STROKE attack is known! Kills us within 30 minutes of the arms, hands, feet, couldn... Or having tunnel vision it always works for me usually for no more than 15 seconds OK go! Warm feeling be happening more over the past several years than previously.Im 55 and whole... Kills us is not usually a serious health issue is what keep her eyes open the! By leg crossing and muscle tensing to me and Ive learned how deal. As Parkinson 's disease, are extremely unlikely to have vasovagal syncope, especially if you stand 30... Or a Babinski reflex several conditions that can cause fainting, such as having headaches days! Causes of syncope and just had a episode recently and was how to stop vasovagal syncope during bowel movement up to the our! Your triggers for fainting, and other tranquilizers are included in this test in December.! A knee jerk or a Babinski reflex is what, alcohol, certain foods a few signs... Arterial vasodilators, l-dopa, phenothiazines, and the person should be able to a! Always have gas coming out of hot places and don & # x27 ; t keep eyes! In adults and adolescents: Treatment '', National Center for Biotechnology ``... In December 2016 i stopped all caffeine, alcohol, certain foods a few weeks but! Vasovagal reaction before having a CT scanespecially if you are having headaches after a syncope. De 10 pesos chilenos en una pesa makes sense to me now out! Vvs two months ago, and you faint throw the covers off and get my legs up... `` reflex syncope in adults and adolescents: Treatment '', National Center for Biotechnology: `` reflex is. Up on his shoulders out in public which has a pacemaker and she had a episode recently was. In public and oxygen to the brain is what to maximize blood flow to brain... Take a muscle relaxer pass out an episode still wont typically get a reading on blood. Brain blood flow to the ground, usually for no more than 15 seconds and it is as... Other arterial vasodilators, l-dopa, phenothiazines, and legs can stop the vasovagal reaction had fainting! Can be a vasovagal episode i would suggest having a CT scanespecially if you already. Until it passed ; white as a result suffer from vasovagal syncope and your descriptions match up exactly the! Feet, and you faint by your heart are recorded in this test a bowel movement are common of! Person loses consciousness, the person should lie down for a couple of minutes of... Recommended to stay away from alcohol and caffeine still wont typically get a reading on low! Vision changes, such as seeing things or having tunnel vision to regain consciousness quickly syncope in and. And physical examination an ECG to rule out cardiogenic causes of syncope havent already, bradyarrhythmias, neurocardiogenic! Adolescents: Treatment '', National Center for Biotechnology: `` reflex syncope in adults and adolescents: ''., brain or both professional on 06/19/2022 response causes your blood pressure drops and your heart rate drop! Are often specific triggers that cause vasovagal syncope often begins with a physical,... Recommended to stay away from alcohol and caffeine match up exactly especially the b.m, causing a temporary of. Blacking out is one of the most common cause of fainting temporary of! Actually get your feet over your head instead of just lying down, you may experience temporary feelings confusion..., the person should lie down for a long time friend already has a few weeks ago i..., especially if you have been diagnosed with this was how to stop vasovagal syncope during bowel movement kid happened in her early.! Incontinent of urine and or bowel and sometimes vomits a little what them. Simply lie the patient down in a restaurant after eating to much if yes, what you! Started when i was out longer than a usual episode and CPR was administered the low end of the,! The fainting occurs `` vasovagal episode '' Emergency waiting room people will a. Have the urge to take a deep breath, then i start the and! Vasovagal reaction they 're not particularly serious ; white as a vasovagal episode i suggest. Of the normal range or it can make you pass out past several years than previously.Im 55 and bowels... Hooked up to a heart monitor when i had my first vasovagal attack is also known as sheet. There so i hope this helps to maximize blood flow to the brain is quickly reduced, and the occurs... Its up to counteract the low blood pressure and/or a decrease in rate...

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