Vasovagal syncope

Question 1

Define 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

Explain the aetiology/risk factors of vasovagal syncope

Answer 2

Vasovagal syncope is a very common cause of fainting
Can be precipitated by:
Emotions (e.g. fear, severe pain, blood phobia)
Orthostatic stress (e.g. prolonged standing, hot weather)

Question 3

Summarise the epidemiology of vasovagal syncope

Answer 3

VERY COMMON

Syncope (of all causes) affects 40% of people

Question 4

Recognise the presenting symptoms of vasovagal syncope

Answer 4

Loss of consciousness lasting a short time
Patients may experience vagal symptoms (sweating, dizziness, light-headedness) before passing out

There may be some twitching of limbs during the blackout

Recovery is normally very quick

Question 5

Recognise the signs of vasovagal syncope on physical examination

Answer 5

Usually NO SIGNS

Question 6

Identify appropriate investigations for vasovagal syncope

Answer 6

Investigations are involved with checking for other causes of syncope

ECG - check for arrhythmia

Echocardiogram - check for outflow obstruction

Lying/standing blood pressure - check for orthostatic hypotension

Fasting blood glucose - check for DM/hypoglycaemia