Transcranial Doppler: a promising cornerstone for precision diagnosis and treatment of vasovagal syncope

Vasovagal syncope (VVS) is the most common type of syncope, and traditional diagnosis and treatment strategies are facing challenges in terms of precision. This article analyzes and evaluates the value of transcranial Doppler (TCD) combined with tilt table test in capturing changes in cerebral hemodynamics and achieving early warning of the disease. Based on the understanding of the pathophysiology of VVS from the perspective of complex system theory and in combination with clinical practice, it discusses key issues such as the standardization of biomarkers, the clinical application of cardiac ganglion plexus ablation, and the hierarchical diagnosis and treatment pathways. Based on this, a refined clinical recommendation scheme covering three levels-"primary screening at the grassroots level-precise classification-stratified treatment"-is proposed, clearly defining the technical standards, classification thresholds, and referral indications for each level, providing an operational framework for building a precise diagnosis and treatment system for VVS that is in line with the actual medical situation in China.