Vasovagal Syncope

• What is a vasovagal episode?

  Syncope

  Due to problem with ANS regulating blood flow to the brain

  Vagus nerve receives strong stimulus (emotion, pain, change in temp) -> stimulates parasympathetic NS -> dilates blood vessels -> cerebral circulation drops -. hypoperfusion of brain tissue -> syncope
• What are the signs & symptoms of vasovagal syncope?

  Prodromal symptoms

  • hot & clammy
  • sweaty
  • heavy
  • dizzy/lightheaded
  • vision going blurry/dark
  • headache

  Get collateral Hx

  • sudden loss of consciousness
  • unconscious for a few seconds to a minute
  • may be some twitching, shaking or convulsion activity
  • may be incontinence

  Postictal period (groggy feeling, confusion, drowsiness, irritability & disorientation)
• What are the Inx for vasovagal syncope?

  Full Hx (inc collateral history if syncope was witnessed)

  Lying & standing BP

  Cardio & neuro exams

  ECG

  BM

  Bloods (FBC, U&Es)

  Echo
• What is the management for vasovagal syncope?

  Reassurance

  Advice

  • avoid dehydration
  • avoid missing meals
  • avoid standing still for long periods
  • when experiencing prodromal symptoms, sit or lie down, have some water or something to eat & wait until feeling better