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Vasovagal syncope is a condition that leads to fainting in some people. It is the most common cause of fainting and is usually thought of as benign.
Many nerves connect with your heart and blood vessels. These nerves help control the speed and force of your heartbeat. They also regulate blood pressure. They control whether your blood vessels should be more open or closed. Usually, these nerves coordinate their actions so you always get enough blood to your brain. Under certain situations, these nerves might give an inappropriate signal. This might cause your blood vessels to open wide. At the same time, your heartbeat slows down. Blood can start to pool in your legs, and not enough of it may reach the brain. If that happens, you may lose consciousness briefly. When you lie or fall down, blood flow to the brain resumes.
Vasovagal syncope is quite common. It most often affects children and young adults, but it can happen at any age. It happens to men and women in about equal numbers. Unlike some other causes of fainting, vasovagal syncope does not signal an underlying problem with the heart or brain.
Several triggers can cause vasovagal syncope. To help reduce the risk of fainting, you can avoid some of these triggers such as:
Older adults may have other specific triggers, for example:
Fainting is the defining symptom of vasovagal syncope. Often, you may have certain symptoms before actually fainting such as:
If you can lie down at the first sign of these symptoms, you will often be able to prevent fainting. When it happens, this type of fainting almost always happens in a sitting or standing position. Not everyone notices symptoms before fainting, however.
When a person does faint, lying down restores blood flow to the brain. Consciousness should return fairly quickly. You might not feel normal for a little while after you faint. You might feel depressed or fatigued for a short time.
Some people have only one or two episodes of vasovagal syncope in their life. For others, the problem is more chronic and happens with no warning.
Your doctor will perform a thorough medical history and physical exam. This will probably include measuring the blood pressure while lying down and while standing. Your doctor will likely obtain an electrocardiogram (EKG) as well, to evaluate the heart’s rhythm. For many children and young adults, this is all that is necessary. Usually, the doctor can safely assume that the fainting is due to vasovagal syncope, and not some form of syncope that is more dangerous.
Sometimes the doctor needs to check for other possible causes for fainting. Because some causes of fainting are dangerous, the doctor has to rule out these other causes. Your doctor might use tests such as the following:
If these tests are normal, you might need something called a “tilt table test.” For this test, you lie down on a board. Someone measures your heart rate and blood pressure while you are lying down and then tilted up for a period of time. If you have vasovagal syncope, you may faint during the upward tilt.
Watch for the warning signs of vasovagal syncope, like dizziness, nausea, or sweaty palms. If you have a history of vasovagal syncope and think you are about to faint, lie down right away. Tensing your arms or crossing your legs can help prevent fainting. Lifting your legs up in the air can also help.
To immediately treat someone who has fainted from vasovagal syncope, help the person lie down and lift his or her legs up in the air. This will restore blood flow to the brain, and the person should quickly regain consciousness. The person should lie down for a little while afterwards.
If you have had episodes of vasovagal syncope, your doctor might tell you how to help prevent fainting. These might include:
Occasionally, you may need medications to help control vasovagal syncope. However, research on these medications has revealed uncertain benefits in vasovagal syncope. These are usually only considered when a person has multiple episodes of fainting. Some of the medications your doctor may advise a trial of include:
If these medications are ineffective, doctors sometimes try orthostatic training. This method uses a tilt table to gradually increase the amount of time spent upright. Rarely, a cardiac pacemaker is necessary.
Vasovagal syncope itself is generally not dangerous. Of course, fainting can be dangerous if it happens at certain times, like while driving. Most people with rare episodes of vasovagal syncope can drive safely. If you have chronic syncope that is not under control, your doctor may advise against driving. This is especially likely if you don’t usually have warning signs before you faint. Ask your doctor about what is safe for you to do.
See a doctor right away if you have recurrent episodes of passing out or other related problems.
Vasovagal syncope is the most common cause of fainting. It happens when the heart slows and the blood vessels open too wide, causing a temporary lack of blood flow to the brain. It is generally not a dangerous condition.
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