Orthostatic hypotension and vasovagal syncope

Orthostatic hypotension follows a change to an upright position and reflects an inadequate circulation response. Vasovagal syncope is a reflex that can be triggered by fear, pain, emotional distress, prolonged standing, heat, or seeing blood. It may cause warmth, sweating, nausea, pallor, tunnel vision, and a slowing pulse before a person faints. Symptoms can overlap, so the circumstances and warning signs matter when a clinician assesses the episode.

At the first warning, lie flat and raise your legs, or sit with your head lowered if lying down is not possible. Loosen tight clothing, move away from heat, and ask someone to stay nearby. After recovery, rise slowly and avoid driving or hazardous activity until you have been assessed if fainting is unexplained or recurrent. Keep a record of the trigger, posture, warning symptoms, recovery, and any injury.

Seek urgent help for fainting during exercise, without warning, or with chest pain, severe breathlessness, palpitations, seizure-like movements, prolonged confusion, pregnancy, or a serious injury. A first faint, repeated fainting, or an episode with a family history of sudden heart problems should receive medical assessment even if recovery is quick.

Ask whether the episode sounds postural, vasovagal, or related to another cause. Discuss blood-pressure and pulse checks, medicine review, and whether heart testing is needed based on your symptoms.