Syncope is realized as a self-terminating and transient loss of consciousness (LOC) together with quick onset, short period combined with spontaneous, complete and prompt recovery. Syncope is described by universal cerebral hypoperfusion (Aydin et al., 2010)

The reflex syncope contains various kinds of syncope which all present a typical trigger case and an induction of cardiovascular reflexes. However, activation of these parasympathetic and sympathetic reflex loops initiates either bradycardia (cardioinhibitory kind) or hypotension (vasodepressor kind) or both (mixed kind) (Brignole et al., 2000).

Present guidelines categorize reflex syncope into situational, vasovagal, carotid sinus syncope, as well as atypical reflex syncopes. Anyway, ‘vasovagal’ syncope, also recognized as the ‘common faint’, is mediated by orthostatic stress or by emotion. It is commonly preceded by prodromal signs of autonomic activation (nausea, pallor, sweating) (Moya et al., 2019).

The pathophysiology of vasovagal syncope is described by a reflex activation stimulating a quick reduction in heartbeat and a decrease of vascular tone (Kapoor, 2002). An instructive and informative talk with the patient concerning the benign nature and prediction is the initial step in the therapy of patients with vasovagal syncope. However, situations stimulating vasovagal reflexes should be bypassed like a hot environment, prolonged standing, humid atmosphere, and decreased water intake (Moya et al., 2009). A decrease or stoppage of vasoactive substances may be substantial (Gaggioli et al., 1997).

Discontinuation of hypotensive medication therapy for concomitant situations is an essential first line measurement for the prohibition of syncope recurrences in numerous subjects, particularly in older patients. Furthermore, substitution of salt and intake of isotonic drinks extends the circulating blood volume as well, it may develop venous return (El-Sayed and Hainsworth, 1996).

Counterpressure maneuvers like leg crossing and hand-grip may prevent vasovagal syncope by elevating the venous return. Leg crossing integrated with muscles tensing at the beginning of prodromal signs can postpone or even block vasovagal syncope (van Dijk et al., 2006).

Vasovagal syncope is a popular reason of syncope which, if frequent, can have various negative outcomes like injury and occupational disability. Diverse medications can be utilized to reduce the return of vasovagal syncope but there are no medications that can be utilized by patients to block a perceived vasovagal event (Hutson et al., 2022).

A number of medications have been examined in the therapy of vasovagal syncope. These have contained β-blockers, theophylline, disopyramide, ephedrine, midodrine, clonidine, etilefrine, scopolamine, and serotonin reuptake inhibitors (SRI) (Moya et al., 2009).

Finally, an Instructive and Informative Journey inside Vasovagal Syncope explains the whole sequence of situations that a sick person experiences within an offered healthcare framework or across suppliers, from scheduling a meeting for a constant checkup to receive therapy for a disease or injury. An Instructive and Informative Journey is a continuing procedure that combines all sections of the healthcare ecosystem, from medical centers to doctors, outpatient treatment, and specialty care. The journey to preferable health is constantly continuous, but what you perform now can manufacture a huge effect on what you face in the future.

References:

Aydin, MA., Salukhe, TV. et al. (2010). Management and therapy of vasovagal syncope: A review. World J Cardiol., 2(10):308-15.

Brignole, M., Menozzi, C. et al. (2000). New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Vasovagal Syncope International Study. Europace, 2:66–76.

El-Sayed, H. and Hainsworth, R. (1996). Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope. Heart., 75:134–140.

Gaggioli, G., Bottoni, N. et al. (1997). Effects of chronic vasodilator therapy to enhance susceptibility to vasovagal syncope during upright tilt testing. Am J Cardiol., 80:1092–1094.

Hutson, P., Guieu, R. et al. (2022). Safety, Pharmacokinetic, and Pharmacodynamic Study of a Sublingual Formula for the Treatment of Vasovagal Syncope. Drugs R D, 22: 61–70.

Kapoor, WN. (2002). Current evaluation and management of syncope. Circulation., 106:1606–1609.

Moya, A., Sutton, R., Ammirati, F. et al. (2009). Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Eur Heart J., 30:2631–2671.

van Dijk, N., Quartieri, F. et al. (2006). Effectiveness of physical counterpressure maneuvers in preventing vasovagal syncope: the Physical Counterpressure Manoeuvres Trial (PC-Trial). J Am Coll Cardiol., 48:1652–1657.