Vasovagal Syncope

What is vasovagal syncope?

Vasovagal syncope is sudden fainting caused by a sudden drop in heart rate and blood pressure when your body overreacts to certain emotional or neurologic triggers. A loss of consciousness occurs due to reduced blood flow to the brain.

Those with vasovagal syncope will also experience certain skin, vision, circulatory, and other associated symptoms. These may include pale skin or the sensation of breaking out in a cold sweat, dilated pupils, tunnel vision or blurred vision, a slow or weak pulse, lightheadedness, frequent yawning, headache, nausea, and feeling hot or overheated with no clear cause.

Vasovagal syncope is not usually harmful or indicative of a more serious condition. Treatments include rest, the implant of a pacemaker, dietary changes, avoiding triggers, and maintaining good circulation in the lower body.

You do not need immediate treatment for this condition, as it is normal and not a cause for concern. However, since it has been going on for a while, you may want to discuss the fainting episodes with your doctor over the phone to discuss if any intervention is needed. You may require medical attention if during the fainting episode you fell and injured a body part.

Vasovagal syncope symptoms

Before fainting occurs, the following indicators of vasovagal syncope may be present, which can be defined by skin, vision, and circulation-related symptoms as well as a few others.

Skin-related Symptoms

Skin-related symptoms that may occur include:

• Appearing pale, gray, or ashen
• Breaking out in a cold sweat

Vision-related Symptoms

Vision-related symptoms of vasovagal syncope include:

• Dilated pupils
• Blurred vision
• Fading vision: This phenomenon is also called "graying out," meaning that vision fades away except for a small area directly in front of you. This is also called "tunnel vision."

Circulation-related symptoms

Some circulatory symptoms may occur, including:

• Slow, weak pulse: Your pulse may be difficult to detect.
• Feeling lightheaded or dizzy: This is from the drop in blood pressure.
• Yawning: This is due to the lack of oxygen in the blood.

Other symptoms

Other symptoms may include:

• Headache
• Nausea
• Feeling hot or overheated: This may occur even in a cool place.

Causes of vasovagal syncope

Vasovagal syncope can be caused by emotional distress, bodily stress or sudden changes, other forms of stress, or heart conditions that can take a toll on the body.

Emotional distress

Experiencing emotional shock and distress can cause an overreaction of the vagus nerve function and lead to fainting. Research has been completed to suggest the origin of this condition from an evolutionary standpoint. Examples include:

• Receiving tragic news
• Witnessing something gory or terrifying
• Seeing blood or having blood drawn

Treatment options and prevention for vasovagal syncope

Vasovagal syncope is usually an acute condition, meaning it is a one-time incident with no lasting effects. Although this a harmless condition in itself, associated harm that can occur due to sudden falls is cause for concern. Treatments include rest, a possible pacemaker, and the avoidance of certain triggers.

Recommended treatments

The following treatments are likely for vasovagal syncope.

• Rest: In most cases, the condition of vasovagal syncope can be treated simply with rest and by allowing at least an hour or so for recovery.
• Pacemaker: If the cause turns out to be an irregular heartbeat, a pacemaker can sometimes correct the heartbeat and prevent any further episodes of syncope.

Avoiding triggers

You should try to avoid the things that commonly trigger fainting as much as possible, including:

• Heat exhaustion
• Dehydration
• Low blood sugar
• Prolonged standing
• Severe emotional distress

Prevention

Vasovagal syncope can possibly be prevented by following certain protocol, such as:

• Quickly getting more blood flow to the brain: If you feel that you might faint, you can try to prevent it by quickly getting more blood flow to the brain. If you are standing, tighten the muscles of the legs to help force the blood upward to the brain. You should also try to lie down with your feet resting higher than your head. If you cannot lie down, you can sit down and place your head low between your knees.
• Dietary changes and prescription medications: You should try to moderately consume more salt and electrolytes as well as drink more water to keep your blood volume up. You can also discuss medications with your medical provider.
• Keeping blood from pooling in the feet and lower legs: You should wear compression stockings and avoid standing for long periods of time. If you feel lightheaded, you can tighten the muscles of your legs.

Here are some over-the-counter (OTC) treatment options and tips that could help manage and prevent future episodes:

Hydration and Electrolyte Balance: Ensuring you're well-hydrated is crucial. Consider an electrolyte solution or tablets to maintain proper hydration and electrolyte levels, especially if you're prone to dehydration.

Compression Stockings: These can help prevent blood from pooling in your legs, thus maintaining blood flow to your brain and reducing fainting episodes.

Cooling Products: If heat is a trigger, cooling towels or wearable fans can help you stay cool in hot environments.

Prognosis

A one-time occurrence of fainting should clear up very quickly. However, you should not try to stand for at least an hour or so after regaining consciousness. The body needs time to regain its normal state and you may faint again if you try to get up too quickly.

When to seek further consultation for vasovagal syncope

You should seek medical attention if your fainting becomes a frequent occurrence or if you lose consciousness for a prolonged period and there is no obvious cause.

If fainting occurs more than once

If this is not the first occurrence of fainting you should see your medical provider to rule out any illness involving the brain, heart, or circulatory system. These may include tumors, heart arrhythmias, or blockage of the arteries. Fainting or severe lightheadedness that happens during exercise can be a serious warning sign, especially if there is a family history of sudden cardiac death.

If you hit your head or lose consciousness

The primary hazard of fainting is the chance of striking your head against a wall, a piece of furniture, or other solid object as you fall. Contrary to what's seen in the movies, a fainting person does not usually sink gracefully to the floor but tends to topple like a falling tree. A brief loss of consciousness is not harmful in itself, but a blow to the head during an unconscious fall can be very dangerous.

If there is no obvious cause

An episode of fainting that has an obvious cause, such as heat exhaustion, is probably not serious as long as it does not happen again and there are no other symptoms of heart disease or circulatory illness. If there was no significant bodily stress or a key moment prior to fainting, you should consult your physician.