Vasovagal syncope (VVS), commonly known as the common faint, is a temporary loss of consciousness that occurs when the body overreacts to certain triggers. This reflex involves the vagus nerve, which transmits signals that cause the heart rate and blood pressure to drop suddenly. The resulting reduction of blood flow to the brain leads to a brief loss of consciousness. Although typically harmless, the resulting fall can cause injury. Understanding the mechanisms and having an action plan is helpful for managing this common condition.
Immediate Actions to Prevent Fainting
Recognizing the warning signs is the first step toward preventing a full fainting episode. These signs can include feeling lightheaded, nauseous, or suddenly warm, along with visual changes like tunnel vision or seeing spots. The moment these symptoms begin, the immediate goal is to increase blood flow back to the brain to abort the reflex.
If possible, quickly lie down and elevate your legs approximately 12 inches above heart level to use gravity to restore cerebral blood flow. If lying down is not feasible, sitting down and placing your head between your knees is an alternative method to achieve the same effect. Remaining in this position until the symptoms completely resolve is necessary before attempting to stand again.
If you are unable to lie down or sit immediately, physical counter-pressure maneuvers can temporarily raise blood pressure. These maneuvers involve tensing large muscle groups to push blood back toward the torso and brain. Examples include tightly crossing your legs and squeezing the muscles together, or interlocking your hands and pulling your arms apart. Engaging these muscles for about 30 seconds, or until symptoms pass, can interrupt the vasovagal reflex and potentially prevent the episode.
Steps for Safe Recovery After an Episode
If consciousness is lost, the recovery period focuses on safety and preventing a recurrence. After waking up, which generally happens in under a minute, it is important to remain lying flat for several minutes, even if you feel recovered. Standing up too quickly significantly increases the chance of a second fainting spell because the body’s blood pressure regulation is still unstable.
Before attempting to stand, slowly move from lying down to a seated position, ideally for a few minutes, to allow your body to adjust to the change in posture. Once upright, a person should check themselves for any injuries sustained during the fall. Rehydration with water or an electrolyte drink can help restore blood volume, which is often depleted and contributes to the episode.
Long-Term Strategies for Reducing Recurrence
Managing vasovagal syncope over time involves identifying and avoiding triggers that initiate the reflex. Common triggers include prolonged standing, exposure to heat, dehydration, and intense emotional distress or pain, such as the sight of blood or a needle. Learning to recognize these situations and proactively removing yourself from them is a primary preventive measure.
A consistent focus on increasing fluid intake is beneficial, aiming for two to three liters of water daily to maintain adequate blood volume. For many individuals, increasing salt intake, such as by adding salt to food or consuming electrolyte supplements, helps retain water and elevate blood pressure. This should be discussed with a healthcare provider first, especially if other health conditions are present.
Simple physical exercises can improve circulation and orthostatic tolerance. Regularly practicing exercises that involve tensing the leg and foot muscles, often called leg pumps, helps reduce blood pooling in the lower extremities. Wearing medical-grade compression stockings can also physically restrict the widening of blood vessels in the legs, further aiding in maintaining central blood pressure.
When to Consult a Healthcare Provider
While vasovagal syncope is generally considered benign, a healthcare professional should evaluate any fainting episode to ensure a correct diagnosis and rule out other serious conditions. It is particularly important to seek medical attention if you have experienced a fainting episode for the first time. A definitive diagnosis helps determine if the cause is truly vasovagal and not cardiac or neurological.
Certain symptoms or circumstances surrounding the faint are considered “red flags” that require prompt medical evaluation. These include fainting during physical exertion, experiencing syncope without preceding warning signs, or if the episode is accompanied by chest pain, palpitations, or shortness of breath. Individuals over the age of 40 who experience their first episode, or those with recurrent, frequent episodes, should also consult a provider to explore management and treatment options.