Diagnosis

Diagnosing vasovagal syncope often involves ruling out other possible causes of your fainting — particularly heart-related problems. These tests may include:

  • Electrocardiogram. This test records the electrical signals your heart produces. It can detect irregular heart rhythms and other cardiac problems. 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 doctor may look for conditions, such as anemia, that can cause or contribute to fainting spells.

Tilt table test

If no heart problems appear to cause your fainting, your doctor may suggest you undergo a tilt table test. For a tilt table test:

  • You lie flat on your back on a table.
  • The table changes position, tilting you upward at various angles.
  • A technician monitors your heart rhythms and blood pressure to see if the postural changes affect them.

Treatment

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

However, if you experience vasovagal syncope often enough to interfere with your quality of life, your doctor may suggest trying one or more of the following remedies.

Medications

A drug called fludrocortisone acetate that's normally used to treat low blood pressure may be helpful in preventing vasovagal syncope. Selective serotonin inhibitors may also be used.

Therapies

Your doctor may recommend ways to decrease 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 may help some people with vasovagal syncope who haven't been helped by other treatments.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Preparing for your appointment

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

What you can do

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

What to expect from your doctor

Questions your doctor might ask you include:

  • What were you doing just before you fainted?
  • What signs and 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 medication?
  • Have you ever had a head injury?
  • Has anyone in your family died suddenly of heart problems?

During the physical exam, your doctor will listen to your heart and take your blood pressure. He or she may also massage the main arteries in your neck to see if that causes you to feel faint.

Aug. 04, 2017
References
  1. Syncope. Merck Manual Professional Version. http://www.merckmanuals.com/professional/cardiovascular_disorders/symptoms_of_cardiovascular_disorders/syncope.html#v1145025. Accessed Dec. 14, 2015.
  2. Stone CK, et al., eds. Immediate management of life-threatening problems causing syncope. In: Current Diagnosis & Treatment: Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com. Accessed Dec. 14, 2015.
  3. Jardine DL. Vasovagal syncope: New physiologic insights. Cardiology Clinics. 2013;31:75.
  4. Aminoff MJ, et al. Seizures & syncope. In: Clinical Neurology. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed Dec. 14, 2015.
  5. Angaran P, et al. Syncope. Neurology Clinics. 2011;29:903.
  6. Olshansky B. Upright tilt table testing in the evaluation of syncope. http://www.uptodate.com/home. Accessed Dec. 15, 2015.