Vasovagal syncope treatment and prevention

Vasovagal syncope reflects a temporary reflex change in blood pressure and heart rate. Treatment starts by identifying triggers such as heat, prolonged standing, pain, needles, emotional shock, or inadequate fluids. A clinician first checks that another explanation, including anaemia, dehydration, hypoglycaemia, or an abnormal rhythm, is not being missed.

Many people can recognise a prodrome: light-headedness, nausea, sweating, warmth, visual dimming, or weakness. Recognising it early gives you time to sit or lie down and prevents injury, which is a central part of management.

Drink enough fluid for your usual needs, avoid overheating, and change position gradually. Do not stand motionless for long periods; gently move your legs and tighten the muscles in your legs, abdomen, and buttocks when warning symptoms start. These actions can help push blood back towards the heart.

For procedures or injections, tell staff about previous fainting and request a reclined or lying position. Medicines are not usually the first step; a clinician may consider them or specialist advice when episodes are frequent, severe, or disruptive after basic measures have been tried.

Call for urgent help if you faint with chest pain, breathing difficulty, a pounding or irregular heartbeat, a major injury, seizure-like movements, or ongoing confusion. Arrange a review for an unexplained, repeated, exercise-related, or lying-down faint. Do not assume a familiar diagnosis if a new episode feels different.

Ask which triggers to avoid, whether muscle-tensing techniques are suitable for you, and whether your medicines, blood pressure, blood count, glucose, or heart rhythm need checking. Discuss what a companion should do if you lose consciousness.