Condition- Vasovagal Syncope

Question 1

What is Vasovagal Syncope?

Answer 1

Loss of consciousness due to a transient drop in blood flow to the brain caused by excessive vagal discharge

Question 2

List three different groups of causes of syncope?

Answer 2

• Reflex syncope (neurally mediated)- this includes vasovagal
• Orthostatic syncope
• Cardiac Syncope
  
  • Arrhthymia
  • Outflow obstruction (AS or HOCM)

Question 3

What is the most common cause of fainting?

Answer 3

Vasovagal Syncope

Question 4

List two main triggers which may precipitate an episode of vasovagal syncope?

Answer 4

• Extreme Emotions
  
  • fear
  • sever pain
  • blood phobia
• Orthostatic stress
  
  • prolonged standing
  • hot weather- dehydration + warmth

Question 5

Alongside LOC list some of the symptoms of syncope

Answer 5

• BEFORE: may experience vagal symptoms:
  
  • sweating
  • pallor (from onlooker)
  • dizziness
  • light-headedness
• DURING: LOC lasting a couple of mins, may get twitching
• AFTER: quick recovery but may get fatigue

Question 6

Which investigation might you conduct in someone who has just had an episode of syncope to rule out other causes

Answer 6

• ECG- check for arrhythmias
• Echo- check for outflow obstruction
• Lying+standing BP- check for orthostatic hypotension
• FBG: check for DM + hypoglycaemia

Question 7

List some of the signs of HOCM

Answer 7

• Usually aymtpomatic
• Jerky carotid pulse
• Double apex beat
• ESM radiating to carotids
• PMHx of sudden cardiac death at young age (<65yrs)