Summary about Disease
Vasovagal syncope (also called neurocardiogenic syncope) is a common cause of fainting. It occurs when your body overreacts to certain triggers, such as the sight of blood, extreme emotional distress, prolonged standing, or heat exposure. This overreaction causes a sudden drop in your heart rate and blood pressure, leading to reduced blood flow to your brain and resulting in a brief loss of consciousness (fainting).
Symptoms
Symptoms of vasovagal syncope typically include:
Lightheadedness
Dizziness
Blurred vision
Feeling warm or cold sweats
Nausea
Pale skin
Tunnel vision (narrowing of your field of vision)
Weakness
Yawning
Fainting (loss of consciousness) Sometimes, individuals may experience only some of these symptoms and not actually faint.
Causes
Vasovagal syncope occurs due to a malfunction in the autonomic nervous system's control of heart rate and blood pressure. Triggers can include:
Emotional stress (fear, anxiety, pain)
Prolonged standing
Heat exposure
Dehydration
Sight of blood
Straining (e.g., during bowel movements)
Intense exercise (less common)
Pain
Crowded, hot places These triggers lead to an exaggerated vagal response, causing the heart rate to slow down and blood vessels to dilate, leading to a drop in blood pressure.
Medicine Used
For many people, lifestyle changes are sufficient to manage vasovagal syncope. Medications are generally not the first line of treatment. However, in some cases where lifestyle changes are insufficient, doctors may prescribe:
Fludrocortisone: This medication helps increase blood volume and blood pressure.
Midodrine: This medication helps to constrict blood vessels, raising blood pressure.
Selective Serotonin Reuptake Inhibitors (SSRIs): In rare cases, these antidepressants might be used to help manage anxiety that may trigger syncope. Beta Blockers: once thought to be effective, these are no longer recommended.
Pacing: In rare and severe cases where a slow heart rate is the primary problem, a pacemaker may be considered. It's crucial to consult with a doctor to determine if medication is appropriate and to discuss potential side effects.
Is Communicable
No, vasovagal syncope is not communicable. It is not caused by an infectious agent and cannot be transmitted from person to person.
Precautions
Avoid triggers: Identify and avoid situations that trigger your syncope.
Stay hydrated: Drink plenty of fluids, especially in hot weather.
Avoid prolonged standing: If you must stand for a long time, try to move your legs to keep blood circulating.
Recognize warning signs: Pay attention to the early symptoms (lightheadedness, nausea, etc.) and take action to prevent fainting.
Counter-pressure maneuvers: Learn and practice techniques like leg crossing, tensing muscles, or clenching your fists to help raise blood pressure.
Sit or lie down: If you feel faint, sit or lie down immediately with your legs elevated.
Cool down: If you feel faint in a hot environment, move to a cooler place.
Inform others: Let family, friends, and coworkers know about your condition so they can assist you if you faint.
Medical alert: Consider wearing a medical alert bracelet or carrying a card that identifies your condition.
How long does an outbreak last?
Vasovagal syncope is not an "outbreak" in the traditional sense of an infectious disease. An individual episode of fainting typically lasts only a few seconds to a few minutes. The person usually recovers quickly after regaining consciousness, although they may feel tired or weak for a short time afterward. The frequency of episodes varies widely from person to person.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical exam: The doctor will ask about your fainting episodes, triggers, and medical history.
Tilt table test: This test involves being strapped to a table that is tilted from a horizontal to an upright position. Your heart rate and blood pressure are monitored to see how your body responds to the change in position.
Electrocardiogram (ECG or EKG): This test records the electrical activity of your heart.
Blood tests: These may be done to rule out other medical conditions.
Sometimes: a Holter monitor may be used to record the heart's activity over 24-48 hours.
Timeline of Symptoms
The timeline of symptoms usually unfolds rapidly: 1. Trigger: Exposure to a trigger (e.g., stress, prolonged standing). 2. Prodrome (Warning Signs): A period of warning symptoms lasting seconds to minutes, including lightheadedness, nausea, sweating, blurred vision, and weakness. 3. Fainting (Syncope): Loss of consciousness, usually lasting seconds to a few minutes. 4. Recovery: Gradual return to consciousness, often accompanied by fatigue or weakness that can last for minutes to hours.
Important Considerations
Ruling out other conditions: It's crucial to rule out other medical conditions that can cause fainting, such as heart problems, seizures, or neurological disorders.
Driving: Fainting episodes can be dangerous while driving. Discuss driving restrictions with your doctor.
Fall risk: Fainting can lead to falls and injuries. Take precautions to prevent falls, such as using assistive devices.
Psychological impact: Frequent fainting episodes can cause anxiety and fear. Seek support from a therapist or counselor if needed.
Lifestyle adjustments are key: Many people can manage vasovagal syncope effectively with lifestyle modifications and by avoiding triggers.