Vasovagal syncope

Diagnosis

Diagnosing vasovagal syncope often begins with a physical exam. During the physical exam, your healthcare professional listens to your heart and takes your blood pressure. Your healthcare professional may massage the main arteries in your neck to see if that causes you to feel faint.

Your healthcare professional also may recommend several tests to rule out other possible causes of your fainting — particularly heart-related conditions. These tests may include:

• Electrocardiogram. This test records the electrical signals your heart produces. It can detect irregular heart rhythms and other cardiac conditions. You may need to wear a portable monitor for at least a day or as long as a month.
• Echocardiogram. This test uses ultrasound imaging to view the heart and look for conditions such as valve problems that can cause fainting.
• Exercise stress test. This test studies heart rhythms during exercise. It's usually conducted while you walk or jog on a treadmill.
• Blood tests. Your healthcare professional may look for conditions such as anemia that can cause or contribute to fainting spells.
• Tilt table test. If no heart conditions appear to cause your fainting, your healthcare professional may suggest that you undergo a tilt table test. During the test, you lie flat on your back on a table that changes positions, tilting you upward at various angles. A technician monitors your heart rhythms and blood pressure during the test to see if changing your posture affects them.

Treatment

In most cases of vasovagal syncope, treatment is unnecessary. Your healthcare professional may help you understand your fainting triggers and discuss ways you might avoid them.

If vasovagal syncope interferes with your quality of life, your healthcare professional may suggest trying one or more of the following remedies:

• Medicines. A drug called fludrocortisone acetate that's usually used to treat low blood pressure may be helpful in preventing vasovagal syncope. Selective serotonin reuptake inhibitors also may be used.
• Therapies. Your healthcare professional may recommend ways to lessen the pooling of blood in your legs. These may include foot exercises, wearing compression stockings or tensing your leg muscles when standing. You may need to increase salt in your diet if you don't usually have high blood pressure. Avoid prolonged standing — especially in hot, crowded places — and drink plenty of fluids.
• Surgery. Very rarely, inserting an electrical pacemaker to regulate the heartbeat helps some people with vasovagal syncope who haven't been helped by other treatments.

Preparing for your appointment

It's a good idea to prepare for your appointment to make the most of your time with your healthcare professional.

What you can do

• Write down details of your symptoms, including any triggers that may have caused you to faint.
• Make a list of all medicines, vitamins and supplements you're taking.
• Write down questions you want to ask, including questions about potential tests and treatments.

What to expect from your doctor

Questions your healthcare professional might ask include:

• What were you doing just before you fainted?
• What symptoms, if any, did you experience before you fainted?
• Have you ever fainted before? If yes, what were you doing before you fainted then?
• Have you recently started taking a new medicine?
• Have you ever had a head injury?
• Has anyone in your family died suddenly of a heart condition?