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Simple Faint

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Vasovagal syncope, vasodepressor syncope, neurocardiogenic syncope



  • Vasovagal syncope, the most common cause of fainting, occurs in otherwise healthy people.  It can affect people of all ages, but is particularly common in young women.  It is also known as neurocardiogenic syncope or vasodepressor syncope.  As these terms suggest, the cause is low heart rate or blood pressure, leading to inadequate circulation to the brain.  This results in fainting, or loss of consciousness (i.e., syncope).

  • Vasovagal syncope almost always happens when the patient is standing.  It is a much less common occurrence when lying down or sitting.
  • Usually the first signs are light-headedness, nausea, pale color, sweating, rapid heart rate, dizziness, or tightness in the throat.  This can last anywhere from a few seconds to a few minutes.
  • Fainting usually follows directly.  This too may last a few seconds to a few minutes.
  • After fainting, patients usually appear flushed, and the heart rate may be slow.
  • Rarely, if not allowed to lie down, patients may die, but this is extremely rare.

  • Vasovagal syncope most often happens to people in stressful or painful situations that cause them anxiety, for example, when having blood drawn or receiving an injection.
  • Some people may faint when they urinate or strain to pass stool.
  • In patients with an overly sensitive nervous system, straining and stress causes blood to pool in the legs.  As a result, blood pressure may drop, reducing circulation to the brain.  In others, the heart rate slows, sending insufficient blood to the brain, causing fainting.

  • Past medical history and thorough examination by the doctor determine diagnosis.
  • It is important to rule out other reasons for the fainting episode(s).
  • In tilt-table testing, the patient lies down on a table that is tilted upright to observe drop in the heart rate or blood pressure.  This test is very effective in identifying patients with very sensitive nervous system.
  • In carotid sinus massage, an individual's carotid artery (in the neck) is massaged while being monitored by the doctor to observe any fainting response.

  • Anyone experiencing the symptoms of fainting should lie down immediately, with the legs elevated.  If possible, whatever provoked the stress or anxiety should be stopped.
  • He should remain lying down until complete recovery.
  • As stated above, fainters may remain unconscious or die if kept upright and not allowed to lie down.  However, this is very rare.
  • In people with frequent or disabling symptoms, treatment with beta-blockers (such as metoprolol or atenolol) may help.  Other medicines that can be used include scopolamine, disopyramide, or theophylline.
  • Some patients may need to be on a high salt diet or wear compression stockings.
  • For people with frequent episodes of fainting caused by slow heart rate, they may need a pacemaker.
  • Vasovagal syncope is usually not a very serious problem and is usually very easily treated.  If care is taken, repeat episodes can usually be avoided.

  • Anyone with a history of fainting when receiving injections or having blood drawn should lie down before the procedure.  He should try not to look at the needle, and the legs should be kept elevated if possible.  The same applies to children who have an aversion to needles.

 


  • Orthostatic Hypotension
  • Chronic venous insufficiency
  • Cardiogenic syncope
  • Vertebrobasilar insufficiency
  • Autonomic neuropathy
  • Antihypertensive medications
  • Cataplexy
  • Drop attacks
  • Hypoglycemia
  • Hypocapnia
  • Hypoxemia
  • Drug overdose
  • Seizure
  • Intracranial hemorrhage
  • Panic disorder
  • Hydrocephalus




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