Vasovagal Syncope

Question 1

Define Vasovagal syncope

Answer 1

Syncope (blackout) characterised by relatively sudden, temporary and self-terminating loss of consciousness due to a temporary inadequacy of cerebral nutrient flow, most often due to the fall in systemic arterial pressure

Question 2

Aetiology of Vasovagal syncope

Answer 2

Triggered by prolonged periods of upright posture, relative dehydration, excessively warm, closed-in environments or extreme emotions, severe pain

Question 3

Epidemiology of Vasovagal syncope

Answer 3

Single most common cause of syncope
Tends to peak in young adults then again in older people
Women are more susceptible to vasovagal faints
Highest frequency is in those with cardiovascular comorbidity

Question 4

Symptoms of Vasovagal syncope

Answer 4

Recurrent faints
Provocative factors
Pre-syncope: nausea, light-headedness, sudden pallor, diaphoresis, diminished vision or hearing
Syncope: quick, no incontinence or jerking
Post-syncope: fatigue but no confusion
Palpitations

Question 5

Signs of Vasovagal syncope

Answer 5

May have bradycardia

Neuralgia

Question 6

Investigations for Vasovagal syncope

Answer 6

ECG: Normal (real out AV block, bradycardia, asystole)

Hb: normal (rule out anaemia)

Glucose: normal (rule out hypoglycaemia)

Beta-HCG: -be (rule out pregnancy)

Cardiac enzymes: normal (rule out MI)

D-dimmer: normal (rule out PE)

Cortisol: normal (rule out adrenal insufficiency

Urea or creatinine: normal (rule out dehydration)