What is Vasovagal Syncope?
Vasovagal Syncope, also called neurocardiogenic syncope, or simply fainting, occurs as a result of the body’s overreaction to a particular trigger. Triggers for many people include such things as the site of blood, extreme emotions, long periods of standing, or severe pain. At its core, Vasovagal Syncope occurs as a result of a neurological reflex that results in fainting. Although every instance of fainting can be concerning, there are two primary reasons as to why Vasovagal Syncope cannot be ignored. The first is that fainting can cause injury, as a person is unlikely to prevent themselves from getting injured in a fall while fainting, so it is important to prevent it from occurring. The second reason that fainting cannot be ignored is that it may be a sign of a more serious underlying medical issue. Vasovagal Syncope accounts for 90% of all episodes of fainting in children and teens.
What causes Vasovagal Syncope?
Vasovagal Syncope occurs primarily when something triggers the vasovagal reflex. This causes blood vessels in the body to quickly dilate, which then leads to blood in the body to begin to pool in the legs. Typically the pooling of blood is accompanied by a slowing of the body’s heart rate, which then leads to a rapid decline in blood pressure. If the loss in pressure is significant enough, the brain is deprived of oxygen, which leads to fainting. The majority of individuals with vasovagal syncope are typically affected solely by the dilation of blood vessels, which acts as the primary cause of loss of consciousness. For some, the slowing of the body’s heart rate may also play a major role in the loss of consciousness.
An individual may be affected by several triggers that lead to fainting. Some of the most common triggers include:
- Sudden and severe pain
- Having blood drawn
- Exposure to traumatic events or sights
- Extreme difficulty in urinating or defecating
- Severe coughing spells
- Standing motionless for long stretches of time
- Overexertion in hot weather
- Excessive alcohol or substance use
If an individual experiences a fainting episode following any of these events, it is highly likely that they may be suffering from vasovagal syncope.
What are the symptoms of Vasovagal Syncope?
Vasovagal Syncope may present with a variety of symptoms prior to a fainting episode. An individual may experience any of the following:
- Pale skin
- Narrowing vision — tunnel vision
- Feeling of warmth
- Cold, clammy, sweat
- Uncontrollable yawning
- Blurry vision
These symptoms, known as prodromal symptoms, generally occur within a few minutes prior to the loss of consciousness and typically occur concurrently with a sensation of “greying out”. Vasovagal Syncope also presents several uniquely defining characteristics. For instance, vasovagal syncope occurs almost exclusively while an individual is standing or sitting up right. It almost never occurs while an individual is lying down. People with vasovagal syncope also usually regain their consciousness within a few seconds after fainting as a result of the blood no longer being able to pool in the legs, given that the body is now lying flat which helps to improve blood pressure almost immediately. Finally, if an individual in the process of fainting is held upright by a bystander with good intentions, it may actually lead to a prolongation of the episode, and even increase the potential for injury because if the victim is being held up right while unconscious, their body may not be able receive adequate blood flow to their brain, which may lead to a potentially adverse outcome.
Remember: Recovery from a vasovagal episode should begin in generally less than a minute. Be careful standing up too soon after a fainting episode. Physical exertion within the first 15 to 30 minutes after an episode may lead to another fainting episode.
How is Vasovagal Syncope diagnosed?
As Vasovagal Syncope is a very situational condition, it may be tough to initially diagnose. In particular, it can occur as a result of relative dehydration, which means that an individual is particularly likely to experience an episode as a result of a viral illness, intense exercise, a warm shower, or even early in the morning. Because of these characteristic features of vasovagal syncope, a doctor should be able to make a correct diagnosis as a result of reviewing the symptoms, medical history, family history, and examining the series of events that led to the eventual episode of fainting.
It is not uncommon that during the process of diagnosis an individual will undergo a physical examination and review of medical history. This is a very typical examination that may also help to reveal similar conditions, such as orthostatic hypotension or postural orthostatic tachycardia syndrome. Moreover, a physical examination can help eliminate other likely possibilities. In rare cases, an individual may undergo specialized testing, particularly a tilt table study.
How is Vasovagal Syncope treated?
Most individuals that experience a singular, isolated, episode of vasovagal syncope generally do not require any treatment or medical therapy at all. Treatment is reserved primarily for individuals who suffer from recurrent episodes. Fortunately, treatment is both quite helpful and may entirely eliminate the issue. There are two general treatments available to those affected by vasovagal syncope – drug therapy and exercise.
If an individual is particularly affected by and experiences high frequency of episodes, then the right course of treatment may be drug therapy. In the past, many individuals with vasovagal syncope were treated using beta blockers. However, more recent studies have indicated that these drugs proved to be less effective than previously thought. Now, the most common drugs used to treat vasovagal syncope are:
Typically individuals have found that one or more of these drugs has helped to reduce the number of episodes of vasovagal syncope they experience. However, finding the “right” combination can be tricky. This requires trial and error, and a lot of patience on the behalf of both the doctor and the patient to determine the best therapy.
Regular exercise may also be a way to prevent the occurrence of vasovagal syncope. Many individuals that are frequently affected by vasovagal syncope may also have a condition known as dysautonomia, which responds well to increased exercise. However, if you have recurrent syncope, it is highly advisable to speak to your doctor before beginning a fitness plan, as you may need to undergo stress testing to determine the limits your body can undergo while exercising. Muscle-tensing exercises are also highly recommended, as they can help to reduce blood vessel dilation, which then helps to increase the flow of blood back to the heart. Some of these exercises include crossing your legs while tensing your abdomen and buttocks, tensing the arms while clenching your fists, tensing your leg muscles, and even squeezing a rubber ball. Some individuals have found that these exercises can entirely abort an episode of fainting.
Vasovagal Syncope compensation
Although vaccines save many more lives than they harm, there is always the potential risk of an adverse reaction when a vaccine is administered. One such adverse reaction is vasovagal syncope, which most frequently affects adolescents, particularly females, from 11 to 18 years of age. While there have been reports of individuals fainting from nearly all vaccines three particular ones tend to stand out: HPV, MCV4, and Tdap. However, because these vaccines contain different ingredients, most experts believe that it isn’t the vaccine, but rather the administration process that leads to fainting. It is also important to note that the vaccine injury isn’t typically the fainting itself, but that fainting leads to harm from an injury like a subsequent fall a victim may experience. As such, it is the responsibility of the vaccine administrator to be aware of and recognize the prodromal symptoms of vasovagal syncope and to prevent the patient from getting injured. If you fainted after the administration of a vaccine and were injured as a result then you should speak to one of our vaccine injury attorneys as soon as possible.
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