Treatment for Vasovagal Syncope

Vasovagal syncope is fainting caused by a complex reaction involving the nerves and blood vessels in the body. The syncope occurs as a result of a sudden drop in blood pressure or heart rate. This causes a brief lack of blood flow to the brain. It's the most common cause of fainting. Unlike other causes of fainting, it's not a sign of a significant problem with the heart or brain.

Say "VAY-zoh-VAY-guhl SIHNK-oh-pee."

If you have had episodes of vasovagal syncope, your doctor may tell you how to help prevent fainting. These might include:

• Staying away from known triggers, such as standing for a long time or getting too hot.
• Stopping medicines that lower blood pressure, such as diuretics.
• Eating foods with more salt, to help keep up blood volume.
• Drinking plenty of fluids, to maintain blood volume.
• Doing moderate exercise, such as lower leg strength training.
• Wearing support stockings to prevent blood pooling in the legs while standing.

In some cases, your doctor may prescribe a medicine to help control vasovagal syncope. Medicine may or may not work. Your doctor may have you try one of the following:

• Alpha-1-adrenergic agonist, such as midodrine, to increase your blood pressure
• Corticosteroids, such as fludrocortisone, to help increase your sodium and fluid levels
• Selective serotonin reuptake inhibitors to manage your nervous system response

If these medicines don't work for you, your doctor may advise orthostatic training. This method uses a tilt table to gradually increase the amount of time you are upright. In rare cases, you may need a cardiac pacemaker to prevent ongoing fainting.

To help reduce the risk of fainting, try to stay away from triggers, such as:

• Standing for long periods.
• Getting too hot.
• Exercising for a long time.
• Feeling intense emotion, such as fear.
• Feeling intense pain.
• Seeing blood or a needle.

Try to stay away from situations that put you at risk. Be sure to stay well hydrated. Don't skip meals.

Watch for the warning signs of vasovagal syncope. These can include:

• Nausea.
• Warm, flushed feeling.
• Face that turns pale.
• Sweaty palms.
• Dizziness.
• Blurred vision.

If you think you are about to faint, try one or more of these tips:

• Lie down right away.
• Prop your feet up so that they are higher than your head.
• Tense up your arms.
• Cross your legs.

If you faint, once you regain consciousness, rest for a little while before getting up and moving around again.

Fainting can be dangerous if it happens at certain times, like while driving. If you have chronic syncope that is not under control or if the cause of your syncope is unknown, your doctor may advise you not to drive. This is especially important if you don't have warning signs before you faint. Talk with your doctor about what's safe for you to do.

Contact your doctor if you have fainting that occurs more often or if you sustain significant injury from your fainting spell.

Unexplained syncope or fainting, especially in older people, can actually be signs of a serious life-threatening condition, such as a heart attack. Call 911 or get medical care right away if the cause of syncope is not known.

Don't drive yourself to the emergency department if you have had a syncopal episode. This is to prevent injury to yourself or other passengers or drivers if another episode occurs while you are driving.