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Menstrual Blood Spells, Alchemy and Divine Order of Nature

Heart Health Heart Disease Causes & Risk Factors What Is Vasovagal Syncope? The Most Common Cause of Fainting By Richard N. Fogoros, MD Updated on October 19, 2022 Medically reviewed by Richard N. Fogoros, MD Print Table of Contents View All Table of Contents Symptoms Causes Risk Factors When to See a Healthcare Provider Diagnosis Treatment Prevention Frequently Asked Questions Vasovagal syncope is when your body reacts so strongly to a trigger like having blood drawn or being scared that your heart rate and blood pressure plummet, causing you to faint. The sudden nature of this reaction and the temporary loss of consciousness that occurs may lead to falls and injuries. Sometimes vasovagal syncope can be due to an underlying condition, such as dehydration, or a side effect of medications, so it’s important that you mention it to your healthcare provider. This article explains the different phases of a fainting episode due to vasovagal syncope. It also discusses the symptoms and causes of the condition, as well as how it can be treated and prevented. Verywell / Brooke Pelczynski What Are Symptoms of Vasovagal Syncope? When you faint as a result of a vasovagal response, it can be sudden but sometimes you’ll have warning signs a few seconds or minutes before. These signs are called the prodrome of syncope. Symptoms that occur after you regain consciousness are called postdromal symptoms. Prodromal Symptoms Prodromal symptoms of syncope can include: LightheadednessRinging or buzzing in the earsVisual disturbances, such as “shimmering” vision or tunnel visionSudden sweatingSudden nausea Prodromal symptoms may be followed by a sensation of “graying out,” in which colors and light become dim. This is followed by a loss of consciousness. The time between the onset of prodromal symptoms and actually passing out can range from a few minutes to just a second or two. If you feel like you’re going to faint, you may be able to stop the episode by lying down with your legs up or sitting in a chair with your head between your knees. Wait until you feel better before trying to stand up. Vasovagal Episode Symptoms Episodes of vasovagal syncope have several defining symptoms and features: They almost always occur while standing or sitting up. This is because more blood goes to your legs when you are standing and your blood pressure drops. Fainting almost never happens when someone is lying down.People usually regain consciousness a few seconds after falling or being helped to the ground. This is because your normal blood pressure is restored in the lying-down position.If someone tries to hold you up during a vasovagal episode, being in the standing position can prolong the time you are unconscious. What To Do If Someone Has Vasovagal Syncope If you see somebody faint, lay the person on their back and raise their legs above the level of their heart. Loosen any belts, collars, or other tight clothing/accessories and call for professional medical help. Postdromal Symptoms After an episode of vasovagal syncope, many people will feel nauseous, dizzy, and extremely tired for a few hours. Sometimes these symptoms can last for a day or even longer. Until these symptoms disappear, you are at risk of fainting again. Therefore, you will need to avoid driving, climbing ladders, or doing anything that could be dangerous if you faint again. You should also be aware of the warning signs of another fainting episode. What Causes Vasovagal Syncope? Vasovagal syncope occurs when something triggers the vasovagal reflex, which causes blood vessels to dilate (widen) suddenly. Dilation of the blood vessels causes a significant amount of the blood in the body to pool in the legs. This pooling is often accompanied by a slowing heart rate. As a result, the blood pressure will suddenly drop. If the drop in blood pressure is enough to rob the brain of the amount of oxygen it needs, fainting occurs. Common Triggers Common triggers of vasovagal syncope include: Sudden, severe painHaving your blood drawnBeing exposed to a traumatic sight or eventHigh levels of stress, anxiety, or fearStraining while urinating or having a bowel movementA severe coughing spellHyperventilation (breathing too fast)Standing still for long periods of timeOverexerting yourself in hot weatherExcessive alcohol or substance use Vasovagal syncope is more likely to occur when a person is dehydrated. Causes of dehydration can include a viral illness, vigorous exercise, or sleeping through the night without drinking water. Who’s at Risk for Vasovagal Syncope? The reflex that causes vasovagal syncope can affect anyone. It is likely that most people will have a fainting episode sometime during their lives. Young Adults and Adolescents Vasovagal syncope can occur at any age but is more common in adolescents and young adults than in older people. People Prone to Recurrent Syncope Some people are particularly prone to vasovagal episodes and may faint even with relatively mild triggering events. These people tend to have recurrent episodes of syncope, beginning in adolescence. They will often have several different kinds of triggers. Those With Dysautonomia Rarely, some people have frequent vasovagal syncope that is so difficult to treat that they become virtually disabled by it. This can be associated with a form of dysautonomia, an imbalance of the autonomic nervous system. The autonomic nervous system is the part of the nervous system that controls things like our heartbeat and breathing. Dysautonomia makes a person very prone to the vasovagal reflex that causes syncope. It’s often accompanied by other symptoms of the dysautonomias, such as: Abdominal bloating or crampsDiarrheaConstipationExtreme fatigueVarious aches and pains When to See a Healthcare Provider Contact your doctor if you experience your first-ever episode of syncope. If you’ve already been diagnosed with vasovagal syncope, see your doctor if you are pregnant or have recurrent episodes. Get medical attention right away if you other symptoms before you faint, such as: Blurred visionChest painConfusionTrouble talkingShortness of breathIrregular heartbeat How Is Vasovagal Syncope Diagnosed? Your healthcare provider will review your symptoms, medical history, and family history. They will then ask about the events leading up to your fainting episode. The physical exam of people with vasovagal syncope is usually completely normal. However, the exam is often helpful in identifying similar conditions, including: Orthostatic hypotension: With orthostatic hypotension, your blood pressure falls when you stand up, and you may feel dizzy or lightheaded. Postural orthostatic tachycardia syndrome (POTS): POTS is a condition in which a person becomes lightheaded and also has heart palpitations (irregular beats) when they stand up. Sometimes tests are needed to diagnose vasovagal syncope. For example, you might need to have a tilt table study. In this test, you are strapped to a table that tilts upward to put you in a position similar to standing. This allows the doctor to measure your heart rate and other factors that may be responsible for fainting episodes. A tilt table study can help distinguish vasovagal syncope from orthostatic hypotension. How Is Vasovagal Syncope Treated? People who have a single, one-time episode of vasovagal syncope generally do not need any medical treatment at all. But if you have had recurrent episodes, you are likely to have even more episodes unless you are treated. These fainting episodes can come at the most inconvenient or impractical times and can greatly disrupt your life. While vasovagal syncope is not life-threatening, injuries that result from falling may be dangerous. Fortunately, treatment is usually helpful. There are two main types of therapy for vasovagal syncope: medication and exercise. Medications Medications can help regulate blood pressure and heart rate, and the ones that may help treat vasovagal syncope include: Midodrine: A drug that causes narrowing (constriction) of the blood vesselsNorpace (disopyramide): An antiarrhythmic drug that regulates your heartbeatSelective serotonin reuptake inhibitors: a type of antidepressantTheophylline: Typically used to treat asthma Exercises Some people have been able to stop an episode of vasovagal syncope by immediately doing exercises that tense the muscles. These exercises can reduce blood vessel dilation and increase the amount of blood being returned to the heart. Examples include: Crossing your legs and squeezing them togetherTensing your arms with clenched fistsTensing your leg muscles, abdomen, and buttocksSqueezing a rubber ball If you have recurrent syncope, meet with your healthcare provider before starting a fitness plan. You may need to undergo stress testing and other exams to determine how much exercise you can do safely. Pacemakers (a device that regulates the heartbeat) were once thought to be helpful in people with vasovagal syncope. This is no longer thought to be true. How Can You Prevent Vasovagal Syncope? People who have had one or two episodes of vasovagal syncope often learn to recognize the warning signs. You can usually prevent an episode by lying down and elevating your legs. On the other hand, trying to “fight off” an episode of vasovagal syncope by forcing yourself to remain standing or sitting up and “willing yourself” not to faint almost never works. Summary Vasovagal syncope is the main cause of fainting. It occurs when someone is upright and their blood pressure drops. This causes them to lose consciousness temporarily. Sometimes, fainting is a one-time event. For other people, it may happen frequently. Things that can trigger an episode of vasovagal syncope include having your blood drawn or an emotionally upsetting event. When diagnosed properly, the condition can usually be managed with medications and/or certain exercises. A Word From Verywell If you have fainted or faint from time to time, it’s most likely due to vasovagal syncope. Most people who have episodes of vasovagal syncope lead normal lives. When fainting occurs frequently, however, it can disrupt your life. If you have had vasovagal syncope—especially more than one episode—you should learn as much as you can about this condition. Learning the things that trigger it and how to recognize warning symptoms can help you stop an episode or prevent future ones. Frequently Asked Questions Is there anything I can do to prevent vasovagal syncope? If you’re prone to syncope (fainting), avoid triggers such as excessive heat, stress, dehydration, extreme pain, and prolonged exercise or standing. Can certain foods impact vasovagal syncope symptoms? Eating a diet slightly higher in salt may help prevent syncope symptoms by keeping blood pressure up. Check with your doctor before adding extra salt to your diet. What are the after-effects of fainting? After-effects of fainting can include nausea, dizziness, fatigue, and appetite loss. These can last a few hours to multiple days. Fainting again is more likely while these symptoms are present, which is why you should avoid potentially dangerous situations, like driving. Is vasovagal syncope a form of anxiety? There’s a strong link between vasovagal syncope and anxiety, and it can have a cyclical effect: Strong feelings of stress and anxiety may be a trigger for syncope. Recurrent syncope can increase anxiety and other mood disorders like depression. Learn More: Stress vs. Anxiety: What Are the Differences? 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Blanc JJ. Syncope: Definition, epidemiology, and classification. Cardiol Clin. 2015;33(3):341-5. doi:10.1016/j.ccl.2015.04.001 Cedars-Sinai. Vasovagal syncope. Cleveland Clinic. Syncope. Jeanmonod R. Vasovagal episode. StatPearls. Zyśko D, Szewczuk-Bogusławska M, Kaczmarek M, et al. Reflex syncope, anxiety level, and family history of cardiovascular disease in young women: case-control study. Europace. 2015;17(2):309-313. doi:10.1093/europace/euu200 Cleveland Clinic. Dysautonomia. Johns Hopkins Medicine. Tilt table testing. Gopinathannair R, Salgado BC, Olshansky B. Pacing for vasovagal syncope. Arrhythm Electrophysiol Rev. 2018;7(2):95-102. doi:10.15420/aer.2018.22.2 Vaddadi G, Corcoran SJ, Esler M. Management strategies for recurrent vasovagal syncope. Intern Med J. 2010;40(8):554-60. doi:10.1111/j.1445-5994.2010.02295.x Additional Reading Sumner GL, Rose MS, Koshman ML, et al. Recent history of vasovagal syncope in a young, referral-based population is a stronger predictor of recurrent syncope than lifetime syncope burden. J Cardiovasc Electrophysiol. 2010;21:1375.doi:10.1111/j.1540-8167.2010.01848.x By Richard N. Fogoros, MD Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit

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