Vasovagal Syncope

Question 1

Definition

Answer 1

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

Question 2

Aetiology/risk factors

Answer 2

· Vasovagal syncope is a very common cause of fainting

· Can be precipitated by:
o Emotions (e.g. fear, severe pain, blood phobia)
o Orthostatic stress (e.g. prolonged standing, hot weather)

Question 3

Epidemiology

Answer 3

· VERY COMMON

· Syncope (of all causes) affects 40% of people

Question 4

Presenting symptoms

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

Signs on physical examination

Answer 5

Usually NO SIGNS

Question 6

Investigations

Answer 6

· Investigations are involved with checking for other causes of syncope

o ECG - check for arrhythmia

o Echocardiogram - check for outflow obstruction

o Lying/standing blood pressure - check for orthostatic hypotension

o Fasting blood glucose - check for DM/hypoglycaemia