Before losing consciousness, some of the early signs and symptoms presented by vasovagal syncope patients include lightheadedness, nausea, extremely high or extremely low body temperature (often followed by sweating), tinnitus, palpitations, confusion, a slight inability to speak, often followed by mild stuttering, nervousness and visual disturbances are other symptoms that can occur as well [8].

The symptoms often last for a few seconds before the loss of consciousness begins. The loss of consciousness often happens when the individual is sitting up or standing. As soon as the sufferer passes out, they fall down. At this point blood flow to the brain is restored instantaneously. A seizure may result if the individual doesn’t fall into a fully flat supine position and the head stays elevated above the trunk as blood will unable to quickly return to the brain. 

• Falling

  These new data seem to indicate that some unexplained falls could be cases of atypical VVS/carotid sinus syncope with retrograde amnesia. [ncbi.nlm.nih.gov]

  As soon as the sufferer passes out, they fall down. At this point blood flow to the brain is restored instantaneously. [symptoma.com]

• Unconsciousness

  We need to be aware of unconsciousness because of phobia when trying to insert contact lenses. [ncbi.nlm.nih.gov]

  When the blood flow to your brain decreases you will most likely become faint or dizzy and you can become unconscious. [gazettereview.com]

  This results in a sudden loss of blood flow to the brain, which leads to equally sudden unconsciousness. [buoyhealth.com]

  Prolonged unconsciousness, lasting more than 5-10 minutes once lying down. [jpaget.nhs.uk]

  While it may be an inconvenience or sometimes an embarrassment to a patient, being unconscious is not normal. It may be easily explained...but it's not normal. [medicinenet.com]

• Anemia

  Synonym(s): vasodepressor syncope. vasovagal syncope See FAINTING. syncope a temporary suspension of consciousness due to cerebral anemia; fainting. cardiac syncope sudden loss of consciousness due to cerebral anemia caused by ventricular asystole, extreme [medical-dictionary.thefreedictionary.com]

  Mild blood loss, poor physical condition, prolonged bed rest, anemia, fever, organic heart disease, and fasting are other factors which increase the possibility of fainting in susceptible individuals. [healthcentral.com]

  Susceptible individuals may be especially prone to these fainting episodes if any of the following conditions are present: mild blood loss; anemia; fever; hypoglycemia; or injury. [diversalertnetwork.org]

  […] disturbances in consciousness neca (incl. syncope, syncope vasovagal, loss of consciousness), dyskinesia, dizziness postural, lethargy Last Update: 2017-04-26 Usage Frequency: 1 Quality: Finnish vatsakipu, happorefluksi, akne, alkalisen fosfataasin nousu, anemia [mymemory.translated.net]

• Pallor

  Clinical findings Abrupt loss of vascular tone; nausea; diaphoresis; pallor. [medical-dictionary.thefreedictionary.com]

  Children with VVS had symptoms of dizziness, pallor, blurred vision, nausea, and some had syncope. Erythrocyte H2S production was measured by a sulphur-sensitive electrode. [ncbi.nlm.nih.gov]

  […] room If no preventative measures are taken Light-headedness Swimming sensation Dizziness ‘Cold sweat’ Fatigue Blurred and fading vision Palpitations (in young patients) Sounds ‘coming from a distance’ Buzzing in the ears Just prior to the faint Facial pallor [syncopedia.org]

  Physical examination was normal except slight pallor skin. ECG revealed low atrial rhythm characterized with negative P-waves in precordial (V1-V6) and inferior leads (II, III, aVF) (Panel A). [ajconline.org]

  In the second to minutes leading up to the fainting, the patient may feel weakness, nausea, pallor, and sweating. [courses.washington.edu]

• Severe Pain

  If the egg grows and ruptures the fallopian tube, she will experience sudden and severe pain, feeling faint or dizzy, vomiting, diarrhoea, and shoulder pain. [fi.bab.la]

  Causes include: standing up too quickly – this could be a sign of low blood pressure not eating or drinking enough being too hot being very upset, angry, or in severe pain heart problems taking drugs or drinking too much alcohol Symptoms of fainting Fainting [nhs.uk]

  Other causes may include severe pain, exhaustion, or sudden changes in body posture. Some people have a predisposition to these episodes due to a health condition that affects blood pressure or the heart. [medicalnewstoday.com]

• Sighing

  […] measures are taken Light-headedness Swimming sensation Dizziness ‘Cold sweat’ Fatigue Blurred and fading vision Palpitations (in young patients) Sounds ‘coming from a distance’ Buzzing in the ears Just prior to the faint Facial pallor (or green) Yawning Sighing [syncopedia.org]

• Nausea

  Patients with nausea or extreme anxiety should be watched carefully and their symptoms treated. [ncbi.nlm.nih.gov]

  Clinical findings Abrupt loss of vascular tone; nausea; diaphoresis; pallor. [medical-dictionary.thefreedictionary.com]

  They may complain of symptoms including nausea, abdominal pain, clamminess, tremors, lightheadedness, headache, malaise, exhaustion and confusion. [pccoforegon.com]

• Vomiting

  Presyncopal (near fainting) patients may also complain of vomiting, disorientation, and difficulty speaking or seeing. [pccoforegon.com]

  Just before fainting the person may experience a racing heart, feeling of warmth or cold, yawning, vomiting, difficulty talking or disorientation. [childrensheartcentre.com]

  If a sufferer is unable to keep fluids down from nausea or vomiting, they may need intravenous fluid. [en.wikipedia.org]

  […] your chances of fainting: Standing still in one position for a period of time Stressful or emotional situations Hot or warm areas Not eating or drinking enough Seeing blood or having injections Please be aware that if you are unwell with diarrhoea or vomiting [rbht.nhs.uk]

• Constipation

  I had a severe syncope once when I was on enemas for constipation. That’s when I realized it was definitely related to dehydration. After drinking 3 g____s a day for a few days, the constipation completely went away and so did the syncope. [earthclinic.com]

  […] are drugs that increase urination vasodilators, which are drugs that lower blood pressure antipsychotic or antidepressant medication autonomic nervous system dysfunction chronic bleeding heart problems Bowel movements If someone is experiencing severe constipation [medicalnewstoday.com]

  If you are nervous about having blood drawn or other laboratory work done or you are constipated then this also might be a trigger for vasovagal syncope. [gazettereview.com]

• Diarrhea

  […] i.e. vision getting "dark" or "closing in"). [2] Causes [ edit ] Lightheadedness can be simply (and most commonly) an indication of a temporary shortage of blood or oxygen to the brain due to a drop in blood pressure, rapid dehydration from vomiting, diarrhea [en.wikipedia.org]

  It's often accompanied by other symptoms of the dysautonomias, such as: Abdominal bloating or cramps Diarrhea Constipation Extreme fatigue Various aches and pains When to See a Healthcare Provider Contact your doctor if you experience your first-ever [verywellhealth.com]

  They often have other symptoms typical of the dysautonomias, such as abdominal bloating or cramps, diarrhea, constipation, extreme fatigue, and various aches and pains. [heartdisease.about.com]

  anxiety, nervousness Ephedrine sulfate 12.5–25 mg PO TID Tachycardia, tremor, supine hypertension Fluoxetine 10–20 mg PO QD (requires 4–6 weeks of therapy) Nausea, anorexia, diarrhea, agitation Venlafaxine 75 mg XR form PO QD or BID Nausea, anorexia [circ.ahajournals.org]

  Intravascular volume depletion due to vomiting, diarrhea, or hemorrhage can result in OH. [clevelandclinicmeded.com]

• Abdominal Bloating

  It's often accompanied by other symptoms of the dysautonomias, such as: Abdominal bloating or cramps Diarrhea Constipation Extreme fatigue Various aches and pains When to See a Healthcare Provider Contact your doctor if you experience your first-ever [verywellhealth.com]

  They often have other symptoms typical of the dysautonomias, such as abdominal bloating or cramps, diarrhea, constipation, extreme fatigue, and various aches and pains. [heartdisease.about.com]

• Hypotension

  POTS has recently been conflated with VVS when excessive tachycardia is succeeded by hypotension during tilt testing. [ncbi.nlm.nih.gov]

• Tachycardia

  BACKGROUND: Postural tachycardia syndrome and vasovagal syncope are common causes of orthostatic intolerance in children. [ncbi.nlm.nih.gov]

• Orthostatic Hypotension

  Both types of syncope are associated with orthostatic hypotension and are nonlethal. The underlying pathophysiology manifests the vast symptoms suffered by the individual. [ncbi.nlm.nih.gov]

  Recent studies have demonstrated a link between orthostatic hypotension and Alzheimer’s disease. 36 Orthostatic hypotension may also occur owing to single enzyme abnormalities. [circ.ahajournals.org]

  However, in cases of orthostatic hypotension, this doesn't happen, leading to the brain's blood supply being interrupted and causing you to faint. [nhs.uk]

  Orthostatic Hypotension In orthostatic hypotension (postural hypotension), patients tend to faint on standing. One typical cause is depleted extracellular fluid volume, perhaps due to use of a diuretic. [courses.washington.edu]

• Slow Pulse

  The pulse rate slows: Due to the disturbance in the vagus nerve control, the pulse rate slows. This combination of low blood pressure and low pulse rate causes the blood to pool in the legs instead of going to the brain. [buoyhealth.com]

  Profuse sweating Slow pulse. Once an attack starts, the following are likely to happen: Loss of consciousness and falling to the ground, usually for no more than 15 seconds. Eyes remain open but roll up and back into your head. [my.clevelandclinic.org]

• Tinnitus

  Statistical significance was achieved for the analysed signs such as generalized weakness, dyspnea, heart palpitations, cold sweats, feeling of cold or heat, visual disturbances, tinnitus, headache. [ncbi.nlm.nih.gov]

  Before losing consciousness, some of the early signs and symptoms presented by vasovagal syncope patients include lightheadedness, nausea, extremely high or extremely low body temperature (often followed by sweating), tinnitus, palpitations, confusion [symptoma.com]

  English 5 obstipation, oedema, oily skin, perforating duodenal ulcer, pharyngitis, photosensitivity, pollakiuria, polydipsia, polyuria, postnasal drip, pruritus, rash, skin lesion, sneezing, staphylococcal infection, stomatitis, thirst, throat irritation, tinnitus [mymemory.translated.net]

• Leg Cramp

  Head-up tilt of bed 45° Head-up tilt of bed (often will need footboard) Hypotension, sliding off bed, leg cramps Elastic support hose Requires at least 30–40 mm Hg ankle counterpressure, works best if waist high Uncomfortable, hot, difficult to get on [circ.ahajournals.org]

• Muscle Cramp

  Desmopressin An analog of vasopressin used as a nasal spray or pill at 0.2 mg PO every night Hyponatremia Octreotide 25 μg SC BID, may titrate to 100–200 μg TID Nausea, abdominal pain, muscle cramps, hypertension Footnotes Correspondence to Blair P. [circ.ahajournals.org]

• Sweating

  Severe sinus bradycardia and hypotension accompanied by light-headedness, cold sweating, and nausea occurred at 80 degrees head-up position during 4 micrograms/min isoproterenol infusion. [ncbi.nlm.nih.gov]

  After the nerve is stimulated, the heart rate slows, lowering BP and causing sweating and eventually a loss of consciousness. [journals.lww.com]

  Prodromal signs and symptoms First Feeling of warmth Vague nausea Abdominal cramps Desire to sit down Desire to leav the room If no preventative measures are taken Light-headedness Swimming sensation Dizziness ‘Cold sweat’ Fatigue Blurred and fading vision [syncopedia.org]

• Urinary Incontinence

  incontinence (in < 25 %; faecal incontinence is very rare) Abnormal breathing Post-syncopal signs and symptoms After syncope Consciousness recovers quickly Fatigue Persistent pallor Nausea Yawning Weakness Sweating Oliguria Recurrence when standing up [syncopedia.org]

• Dizziness

  A 16-year-old healthy boy had sometimes experienced dizziness when looking at the tips of pens. When he put his finger and the lens close to his eye to insert a soft contact lens, he felt sick and dizzy and fell unconscious. [ncbi.nlm.nih.gov]

  It is also important for patient’s to recognize the feeling of dizziness so that they can react appropriately to their body's signals and either sit or lie down quickly. Once the dizziness has passed, they can slowly stand up again. [pediatricheartspecialists.com]

  Although the prodromal symptoms of dizziness, sweating and nausea may classically precede the syncope or fainting, signs and symptoms and also frequency of syncope may vary among patients. [ajconline.org]

  This causes blood pressure to fall and dizziness as less blood goes to the brain. This is usually relieved by lying down. Vasovagal syncope is not dangerous and usually gets better in time. [newcastle-hospitals.org.uk]

  See also [ edit ] Orthostatic hypotension Dizziness Vertigo Vasovagal response Clouding of consciousness Greyout References [ edit ] External links [ edit ] The MedlinePlus Medical Encyclopedia [en.wikipedia.org]

• Confusion

  As soon as there is a slow-down in heart rate, the resulting lack of blood to the brain brings about fainting and confusion. [symptoma.com]

  They may complain of symptoms including nausea, abdominal pain, clamminess, tremors, lightheadedness, headache, malaise, exhaustion and confusion. [pccoforegon.com]

  If you do pass out, you’ll likely regain consciousness within a few moments, but you might feel: exhausted nauseated lightheaded You may even feel a little confused or just plain “out of it” for a few minutes. [healthline.com]

• Convulsions

  AU - Faden, Ruth R PY - 1977/3 Y1 - 1977/3 N2 - The small risk of fainting or convulsions following IUD insertion is described. The reporting doctors observed 3 cases of convulsions in IUD patients in a 6-month period. [jhu.pure.elsevier.com]

  She had vasovagal syncope with convulsions from vasodilatation and cardiac standstill which lasted for 9.8 sec. The 60 degrees head-up tilt test, nitroglycerin injection and isoproterenol infusion provoked vasovagal reaction. [ncbi.nlm.nih.gov]

  not elsewhere classified R56.0 Febrile convulsions R56.00 Simple febrile convulsions R56.01 Complex febrile convulsions R56.1 Post traumatic seizures R56.9 Unspecified convulsions R57 Shock, not elsewhere classified R57.0 Cardiogenic shock R57.1 Hypovolemic [icd10data.com]

• Vertigo

  It is very important to differentiate vertigo, seizures, light-headedness, seizures, vertigo and hypoglycaemia as other causes. [symptoma.com]

  See also [ edit ] Orthostatic hypotension Dizziness Vertigo Vasovagal response Clouding of consciousness Greyout References [ edit ] External links [ edit ] The MedlinePlus Medical Encyclopedia [en.wikipedia.org]

  […] sĭng′kə-pəl, sĭn′-), syn·cop′ic (sĭn-kŏp′ĭk) adj. syncope Neurology A transient loss of consciousness not explained by other altered states of consciousness in the history of the Pt, often linked to cerebral ischemia; fainting, loss of conciousness or vertigo [medical-dictionary.thefreedictionary.com]

  […] tool=bestpractice.com It has many causes, and is distinct from vertigo, seizures, coma, falls, psychogenic pseudosyncope, drop attacks, transient ischaemic attacks, and states of altered consciousness. [3] Strickberger SA, Benson DW, Biaggioni I, et al [bestpractice.bmj.com]

• Dysautonomia

  This case report describes longstanding idiopathic dysautonomia that can be improved by nonpharmacological treatment, while reminding that this medical condition may also be the cause of syncope. [ncbi.nlm.nih.gov]

  Exercise Many people who have dysautonomia also display a tendency to have vasovagal syncope; indeed, it seems likely that many people with recent vasovagal syncope may actually have a form of dysautonomia. [heartdisease.about.com]

  Dysautonomia makes a person very prone to the vasovagal reflex that causes syncope. [verywellhealth.com]

  Autonomic nervous system problems include acute or subacute dysautonomia, chronic post-ganglionic autonomic insufficiency, and chronic pre-ganglionic autonomic insufficiency. [webmd.com]

There are many medical conditions that may cause syncope. This is why making the correct diagnosis for loss of consciousness is one of the most difficult challenges facing health care providers. The core of the diagnosis of vasovagal syncope is dependent on a clear description by the patient for a particular pattern of triggers and time course. It is very important to differentiate vertigo, seizures, light-headedness, seizures, vertigo and hypoglycaemia as other causes.

For patients with recurring vasovagal syncope, the accuracy of diagnosis can often be improved with any one of the following diagnostic tests [9]:

• Tilt table test
• Echocardiogram
• Holter monitor or event monitor
• Implantation of an insertable loop recorder
• Electrophysiology study

• Sinus Arrest

  Vasovagal syncope with concomitant ventricular asystole and sinus arrest is rare. Aggressive management with permanent pacemaker is strongly advocated in malignant vasovagal syncope. [ncbi.nlm.nih.gov]

  Facts While standing, approximately 300-700 ml of blood pools in the lower extremities which decreases intravascular volume Strong vagal stimulations may induce 4-10 seconds of sinus arrest 15 seconds of asystole is necessary to produce unconsciousness [slideshare.net]

  Patients with a sick sinus node or bradycardia-tachycardia syndrome may experience syncope from sinus arrest or following spontaneous conversion from a supraventricular tachycardia to sinus rhythm with a long sinus pause.20Cardiac conduction system disease [pmj.bmj.com]

Applied tension is a behavioral treatment approach that has been demonstrated to be efficacious for the treatment of vasovagal syncope associated with injection phobia. [ncbi.nlm.nih.gov]

VVS in patients with LV dysfunction may be refractory to treatment and could be associated with poor prognosis. KEYWORDS: Autonomic nervous system; Head-up tilt; Left ventricular dysfunction; Vasovagal syncope [ncbi.nlm.nih.gov]

However, it has not been demonstrated that it has value for establishing the prognosis or selecting treatment. [revespcardiol.org]

All aspects of VVS are covered, including epidemiology, pathophysiology, diagnosis and differential diagnosis, prognosis, therapy and implications for particular activities such as work, driving and physical activity. [springer.com]

[…] also known as vasovagal syncope), which is the most common cause of syncope in both children and adults, accounting for 50-66% of unexplained syncope.1 2 The distinction between neurocardiogenic syncope and other causes of fainting is essential, as the prognosis [bmj.com]

Vasovagal syncope often occurs in response to a trigger and there is often a corresponding malfunction in the parts of the nervous system which regulate the heart rate and blood pressure [4]. As soon as there is a slow-down in heart rate, the resulting lack of blood to the brain brings about fainting and confusion.

Below are some of the main triggers for vasovagal episodes:

• Sensitivity as a result of pain
• Extreme menstural pains
• Pressure on the chest after heavy exercising
• Being present during medical procedures
• Sight of blood
• Biopsy procedures (pre and post)
• Increased stress levels
• Dehydration
• Ingestion of certain medications and addcitive substances
• Heavy emotional swings
• Nervous malfucntions
• In rare cases, low sugar level in blood

The incidence for this condition is 6.2 cases per 100 patient years in the United States [5]. Syncope also reoccurs in less than 3% of affected individuals and also, 10% of affected individuals have a cardiac etiology. Data from around the world also suggest a similar occurrence rate to what is obtainable in the United States.

Vasovagal syncope occurs as a result of cerebral hypoperfusion [6]. Brain parenchyma is dependent on sustained blood flow to be able to provide a constant supply of glucose which is its major metabolic substrate. It is not possible for the brain tissue to store energy in form of high-energy phosphates as is seen in other areas of the body. This is why cerebral perfusion of between 3 to 5 seconds is enough to bring about syncope.

Cerebral perfusion is maintained relatively constant by an intricate and complex feedback system which typically involves arterial pressure, intravascular volume status, metabolic regulation and cerebrovascular resistance with intrinsic autoregulation. When there is a significant defect in any of these or subclinical defects in several of these systems, syncope may arise.

Past studies found that an Anti-Gravity suit (G-suit) can increase blood pressure and has been reported to prevent orthostatic hypotension effectively in patients with diabetes. It is possible that the G-suit can prevent VVS. [ncbi.nlm.nih.gov]

Syncope refers to a self-limited loss of consciousness accompanied by the inability to maintain postural tone. Most of the time, it is followed by spontaneous recovery [1]. The condition doesn’t include seizures, coma, shock or other such states of altered consciousness.

There are many recognised etiologies for syncope but categorization is made into reflex (neutrally mediated), orthostatic and cardiac so as to ensure proper initial evaluation [2]. Cardiac vasovagal syncope has the highest number of mortality while non-cardiac syncope doesn’t have such high mortality. Syncope can result in significant morbidity due to accidents or falls that may occur following its onset [3].

Vasovagal syncope refers to one of the most common causes of fainting. It occurs when the body begins to overreact to certain triggers. The most common triggers are sight of blood and extreme emotional distress.

The vasovagal syncope trigger kicks off a sudden drop in heart rate and blood pressure. This brings about a reduction in blood flow to the brain which leads to a momentary loss of consciousness.

The condition is often harmless requiring no treatment. However, it is possible for patients to get injured during an episode of the condition. The doctor may recommend tests to rule out more serious cases of fainting such as an underlying heart condition.