Vasovagal syncope is the most common cause of fainting and is triggered when a person’s body reacts in an exaggerated manner to factors such as the sight of blood or extreme emotional stress. Loss of consciousness is short and is caused by a sudden drop in heart rate and blood pressure, which reduces the blood flow to the brain. Vasovagal syncope is usually harmless and requires no treatment. However, one can be hurt during an episode of fainting. Your doctor may recommend different types of investigations to rule out other causes, such as heart disease.
Before fainting from a vasovagal syncope, a person may experience any of the following symptoms:
– Pale skin
– Narrowed visual field (will see only what is in front of the visual field)
– Cold sweat
When to consult the doctor
Because fainting may be a sign of serious conditions (cardiac disorders or brain disorders) the physician must be immediately consulted after such an event.
Vasovagal syncope occurs when the nervous system functions that regulate heart rate and blood pressure reacts to certain factors, such as the sight of blood. Slow heartbeat and blood vessels in the legs dilate. This stimulates the blood supply to the veins in the legs, which lowers the general blood pressure.
This decrease in blood pressure associated with slow heart rate reduces the blood flow to the brain and fainting occurs. Although vasovagal syncope can occur at any age, it is recognized mostly in older people.
Among the triggers, the most common are:
– Standing for long periods of time (prolonged standing)
– Exposure to heat
– The sight of blood
– Fear of injuries
– Different types of contractions, such as, for example, during the elimination of feces
Preparing for your appointment
Before the consultation, the patient should note in detail the symptoms they experienced (even the most insignificant details are important) and which may be related to the faint. Also, make a list of all the medicines you use, including vitamins and supplements. It is indicated that the patient writes on a sheet of paper the questions he wishes to address the doctor, including what types of investigations might be needed and what kind of treatment might be appropriate.
Your doctor may ask questions such as:
– What were you doing prior to the faint?
– What signs and symptoms occurred before fainting?
– Were there several episodes of fainting?
– Di you recently begin administering a new treatment?
– Was there any incident during which you hit your head?
– Is there a family history that includes people with heart problems?
During the physical exam, your doctor will measure your blood pressure and heart beat. The specialist could massage the main arteries in the neck, in order to determine whether they could play a role in triggering fainting.
Tests and diagnosis
Vasovagal syncope diagnosis often involves excluding other possible causes, especially cardiovascular ones. The following investigations may be necessary:
– Electrocardiogram – This test records the electrical signals from the heart. It can detect irregular rhythms and other heart problems which can cause fainting. In some cases, it is necessary to wear a portable holter for at least a day or even a month.
– Echocardiography – is a heart imaging test exploration that can detect potential heart problems that could be causes of fainting.
– Stress test – is an investigation that aims to analyse the heart rhythms of people doing exercise of physical activities like jogging.
– Blood – the doctor may suspect diseases like anemia, which could contribute to or even cause fainting.
If fainting is caused by cardiac abnormalities, the doctor may ask the patient to undergo the tilt table test, which includes the following steps:
– The patient lies on his back on a table
– The table will change its position and it will tilt (up, down) from different angles
– A specialist will monitor the heart rate and blood pressure to see if the person is affected by the changes
Treatment and medication
In most cases of vasovagal syncope, the treatment is useless. The doctor may determine the cause of fainting and may make recommendations on how to avoid the events. However, if it affects the quality of life, the specialist could recommend medical treatment, which may include:
– beta blockers like metoprolol, used in particular to treat hypertension
– antidepressants – selective serotonin inhibitors
– blood vessels constrictors – drugs used for regulating the blood pressure or to treat asthma
– therapy – the doctor may recommend techniques to reduce the chances of low blood pressure and peripheral blood accumulation in the legs. These can include physical exercises for the legs, wearing stockings or contracting the muscles when a person stands a long period of time, including salt in the diet if the blood pressure is not high. Avoid prolonged standing and crowded places and consume more fluids.
– surgical intervention – in some cases you may need an electric pacemaker, which helps regulate the heartbeat.
If you feel you might faint, you should lie down and raise your legs. This contributes to normal brain irrigation. If you can not stretch, sit and put your head between your knees until the condition will improve.