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What is vasovagal syncope?

Vasovagal syncope is loss of consciousness or fainting from a fall in blood pressure. It is the most common cause of simple fainting.


How common is it and who can get it?

It is very common and many children and young adults could have had at least one faint. It can happen in any child but is common if there is a family history. It is more common in girls than boys. It represents a hyperactive autonomic nervous system that controls heart rate and blood pressure and its response to postural changes.


How does it present?

A vasovagal syncope is often seen in young people after standing or even sitting in one posture for a long duration of time, with sudden change of posture, in a warm or hot environment with poor ventilation. It can be associated with no preceding symptoms or a slight premonition such as appearing very pale, feeling cold and clammy, or dizzy with hazy vision. Loss of consciousness leads them to fall to the ground, and once they are lying down, consciousness could return reasonably quickly. Injuries are thankfully infrequent. The colour may take some time to return back to normal.


Why would you need to see a paediatric cardiologist?

Syncope of any type can be a distressing symptom for a child or young adult and even more for their parents or carers. It can be a presenting symptom of severe life threatening conditions such as aortic valve stenosis, hypertrophic cardiomyopathy, cardiac arrhythmias or coronary abnormalities. The tests performed by Dr Khambadkone will rule out many of these problems. Tests such as echocardiogram, electrocardiogram (ECG), 24 hour ECG Holter monitoring, event monitoring, exercise testing or tilt testing may help. Dr Khambadkone will ensure a close collaboration with a Paediatrician or a Paediatric Neurologist if necessary as some forms of epilepsy may present in a similar manner.


Would one always find a cause for syncope?


Sometimes the exact cause of fainting remains unknown. Vasovagal syncope may be a diagnosis of exclusion of other conditions.


What are the treatment options?

Once the symptoms pattern is recognised, measures will be put into place to reduce the frequency and severity by avoiding precipitating events. Maintenance of good hydration, control of changes in posture, added salt intake, avoidance of precipitating factors, and lastly some medications may help in controlling symptoms. Medications should always be under supervision of medical personnel. There can be a strong element of stress and psychological problems that may contribute to worsening of symptoms and Dr Khambadkone will explore all causes.

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