U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Vasovagal syncope

MedGen UID:
12060
•Concept ID:
C0042420
•
Disease or Syndrome
Synonyms: Faint, Neurally Mediated; Faints, Neurally Mediated; Neurally Mediated Faint; Neurally Mediated Faints; Neurocardiogenic Syncope; Neurocardiogenic Syncopes; Neurogenic Syncope; Neurogenic Syncopes; Syncope, Neurocardiogenic; Syncope, Neurogenic; Syncope, Vasodepressor; Syncope, Vasovagal; Syncope, Vasovagal, Neurally-Mediated; Syncopes, Neurocardiogenic; Syncopes, Neurogenic; Syncopes, Vasodepressor; Syncopes, Vasovagal; Vasodepressor Syncope; Vasodepressor Syncopes; Vasovagal Syncope; Vasovagal Syncopes
SNOMED CT: Vasovagal syncope (398665005); Vaso vagal episode (398665005); Vasodepressor syncope (398665005); Neurally-mediated syncope (398665005); Vasovagal attack (398665005); Gower's syndrome (398665005)
 
HPO: HP:0012668

Definition

A vasovagal episode or vasovagal syncope is the most common form of reflex syncope. Reflex syncope is a general term used to describe types of syncope resulting from a failure in autoregulation of blood pressure, and ultimately, in cerebral perfusion pressure resulting in transient loss of consciousness. The mechanisms responsible for this are complex and involve both depression of cardiac output as well as a decrease in vascular tone. [from HPO]

Professional guidelines

PubMed

Management strategies for vasovagal syncope.
Ali M, Pachon Maetos JC, Kichloo A, Masudi S, Grubb BP, Kanjwal K
Pacing Clin Electrophysiol 2021 Dec;44(12):2100-2108. Epub 2021 Nov 23 doi: 10.1111/pace.14402. PMID: 34748224
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW
Circulation 2017 Aug 1;136(5):e60-e122. Epub 2017 Mar 9 doi: 10.1161/CIR.0000000000000499. PMID: 28280231
2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope.
Sheldon RS, Grubb BP 2nd, Olshansky B, Shen WK, Calkins H, Brignole M, Raj SR, Krahn AD, Morillo CA, Stewart JM, Sutton R, Sandroni P, Friday KJ, Hachul DT, Cohen MI, Lau DH, Mayuga KA, Moak JP, Sandhu RK, Kanjwal K
Heart Rhythm 2015 Jun;12(6):e41-63. Epub 2015 May 14 doi: 10.1016/j.hrthm.2015.03.029. PMID: 25980576Free PMC Article

Recent clinical studies

Etiology

Vasovagal syncope: An overview of pathophysiological mechanisms.
Longo S, Legramante JM, Rizza S, Federici M
Eur J Intern Med 2023 Jun;112:6-14. Epub 2023 Apr 6 doi: 10.1016/j.ejim.2023.03.025. PMID: 37030995
Cardioneuroablation for Reflex Syncope: Efficacy and Effects on Autonomic Cardiac Regulation-A Prospective Randomized Trial.
Piotrowski R, Baran J, Sikorska A, Krynski T, Kulakowski P
JACC Clin Electrophysiol 2023 Jan;9(1):85-95. Epub 2022 Aug 28 doi: 10.1016/j.jacep.2022.08.011. PMID: 36114133
Vasovagal syncope in humans and protective reactions in animals.
Blanc JJ, Alboni P, Benditt DG
Europace 2015 Mar;17(3):345-9. Epub 2015 Feb 5 doi: 10.1093/europace/euu367. PMID: 25662986
Syncope diagnostic scores.
Sheldon R
Prog Cardiovasc Dis 2013 Jan-Feb;55(4):390-5. doi: 10.1016/j.pcad.2012.10.011. PMID: 23472776
Neurally-mediated syncope.
Brignole M
Ital Heart J 2005 Mar;6(3):249-55. PMID: 15875516

Diagnosis

Tilt testing.
Cooper PN, Sutton R
Pract Neurol 2023 Nov 23;23(6):493-500. doi: 10.1136/pn-2023-003749. PMID: 37726165
Cardioneuroablation for vasovagal syncope: A systematic review and meta-analysis.
Vandenberk B, Lei LY, Ballantyne B, Vickers D, Liang Z, Sheldon RS, Chew DS, Aksu T, Raj SR, Morillo CA
Heart Rhythm 2022 Nov;19(11):1804-1812. Epub 2022 Jun 16 doi: 10.1016/j.hrthm.2022.06.017. PMID: 35716859
Cardioneuroablation for vasovagal syncope and atrioventricular block: A step-by-step guide.
Aksu T, Gupta D, D'Avila A, Morillo CA
J Cardiovasc Electrophysiol 2022 Oct;33(10):2205-2212. Epub 2022 Apr 9 doi: 10.1111/jce.15480. PMID: 35362165
Management strategies for vasovagal syncope.
Ali M, Pachon Maetos JC, Kichloo A, Masudi S, Grubb BP, Kanjwal K
Pacing Clin Electrophysiol 2021 Dec;44(12):2100-2108. Epub 2021 Nov 23 doi: 10.1111/pace.14402. PMID: 34748224
The pathophysiology of the vasovagal response.
Jardine DL, Wieling W, Brignole M, Lenders JWM, Sutton R, Stewart J
Heart Rhythm 2018 Jun;15(6):921-929. Epub 2017 Dec 12 doi: 10.1016/j.hrthm.2017.12.013. PMID: 29246828Free PMC Article

Therapy

Vasovagal syncope: An overview of pathophysiological mechanisms.
Longo S, Legramante JM, Rizza S, Federici M
Eur J Intern Med 2023 Jun;112:6-14. Epub 2023 Apr 6 doi: 10.1016/j.ejim.2023.03.025. PMID: 37030995
Cardioneuroablation for Reflex Syncope: Efficacy and Effects on Autonomic Cardiac Regulation-A Prospective Randomized Trial.
Piotrowski R, Baran J, Sikorska A, Krynski T, Kulakowski P
JACC Clin Electrophysiol 2023 Jan;9(1):85-95. Epub 2022 Aug 28 doi: 10.1016/j.jacep.2022.08.011. PMID: 36114133
Cardioneuroablation for vasovagal syncope: A systematic review and meta-analysis.
Vandenberk B, Lei LY, Ballantyne B, Vickers D, Liang Z, Sheldon RS, Chew DS, Aksu T, Raj SR, Morillo CA
Heart Rhythm 2022 Nov;19(11):1804-1812. Epub 2022 Jun 16 doi: 10.1016/j.hrthm.2022.06.017. PMID: 35716859
Cardioneuroablation for vasovagal syncope and atrioventricular block: A step-by-step guide.
Aksu T, Gupta D, D'Avila A, Morillo CA
J Cardiovasc Electrophysiol 2022 Oct;33(10):2205-2212. Epub 2022 Apr 9 doi: 10.1111/jce.15480. PMID: 35362165
Management of vasovagal syncope.
Ballantyne BA, Letourneau-Shesaf S, Raj SR
Auton Neurosci 2021 Dec;236:102904. Epub 2021 Nov 4 doi: 10.1016/j.autneu.2021.102904. PMID: 34763249

Prognosis

Differential diagnosis of orthostatic hypotension.
Lei LY, Chew DS, Raj SR
Auton Neurosci 2020 Nov;228:102713. Epub 2020 Aug 1 doi: 10.1016/j.autneu.2020.102713. PMID: 32805514Free PMC Article
Syncope in Pediatric Practice.
Singhi P, Saini AG
Indian J Pediatr 2018 Aug;85(8):636-640. Epub 2017 Nov 9 doi: 10.1007/s12098-017-2488-9. PMID: 29119462
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW
Circulation 2017 Aug 1;136(5):e60-e122. Epub 2017 Mar 9 doi: 10.1161/CIR.0000000000000499. PMID: 28280231
Syncope diagnostic scores.
Sheldon R
Prog Cardiovasc Dis 2013 Jan-Feb;55(4):390-5. doi: 10.1016/j.pcad.2012.10.011. PMID: 23472776
Vagally mediated atrioventricular block: pathophysiology and diagnosis.
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970

Clinical prediction guides

Cardioneuroablation for vasovagal syncope: A systematic review and meta-analysis.
Vandenberk B, Lei LY, Ballantyne B, Vickers D, Liang Z, Sheldon RS, Chew DS, Aksu T, Raj SR, Morillo CA
Heart Rhythm 2022 Nov;19(11):1804-1812. Epub 2022 Jun 16 doi: 10.1016/j.hrthm.2022.06.017. PMID: 35716859
International Validation of the Canadian Syncope Risk Score : A Cohort Study.
Zimmermann T, du Fay de Lavallaz J, Nestelberger T, Gualandro DM, Lopez-Ayala P, Badertscher P, Widmer V, Shrestha S, Strebel I, Glarner N, Diebold M, Miró Ò, Christ M, Cullen L, Than M, Martin-Sanchez FJ, Di Somma S, Peacock WF, Keller DI, Bilici M, Costabel JP, Kühne M, Breidthardt T, Thiruganasambandamoorthy V, Mueller C; BASEL IX Investigators†, Belkin M, Leu K, Lohrmann J, Boeddinghaus J, Twerenbold R, Koechlin L, Walter JE, Amrein M, Wussler D, Freese M, Puelacher C, Kawecki D, Morawiec B, Salgado E, Martinez-Nadal G, Inostroza CIF, Mandrión JB, Poepping I, Rentsch K, von Eckardstein A, Buser A, Greenslade J, Reichlin T, Bürgler F
Ann Intern Med 2022 Jun;175(6):783-794. Epub 2022 Apr 26 doi: 10.7326/M21-2313. PMID: 35467933
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW
Circulation 2017 Aug 1;136(5):e60-e122. Epub 2017 Mar 9 doi: 10.1161/CIR.0000000000000499. PMID: 28280231
Syncope diagnostic scores.
Sheldon R
Prog Cardiovasc Dis 2013 Jan-Feb;55(4):390-5. doi: 10.1016/j.pcad.2012.10.011. PMID: 23472776
Vagally mediated atrioventricular block: pathophysiology and diagnosis.
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970

Recent systematic reviews

Association between vitamin D deficiency and vasovagal syncope: A systematic review and meta-analysis.
Khalaji A, Behnoush AH, Tajdini M
Clin Cardiol 2023 Jul;46(7):721-728. Epub 2023 May 24 doi: 10.1002/clc.24035. PMID: 37226313Free PMC Article
Pharmacologic prevention of recurrent vasovagal syncope: A systematic review and network meta-analysis of randomized controlled trials.
Behnoush AH, Yazdani K, Khalaji A, Tavolinejad H, Aminorroaya A, Jalali A, Tajdini M
Heart Rhythm 2023 Mar;20(3):448-460. Epub 2022 Dec 9 doi: 10.1016/j.hrthm.2022.12.010. PMID: 36509319
Cardioneuroablation for vasovagal syncope: A systematic review and meta-analysis.
Vandenberk B, Lei LY, Ballantyne B, Vickers D, Liang Z, Sheldon RS, Chew DS, Aksu T, Raj SR, Morillo CA
Heart Rhythm 2022 Nov;19(11):1804-1812. Epub 2022 Jun 16 doi: 10.1016/j.hrthm.2022.06.017. PMID: 35716859
Yoga as a treatment for vasovagal syncope: A systematic review and meta-analysis.
Abdelazeem B, Abbas KS, Manasrah N, Amin MA, Mohammed SM, Mostafa MR
Complement Ther Clin Pract 2022 Aug;48:101579. Epub 2022 Apr 4 doi: 10.1016/j.ctcp.2022.101579. PMID: 35390588
Did This Patient Have Cardiac Syncope?: The Rational Clinical Examination Systematic Review.
Albassam OT, Redelmeier RJ, Shadowitz S, Husain AM, Simel D, Etchells EE
JAMA 2019 Jun 25;321(24):2448-2457. doi: 10.1001/jama.2019.8001. PMID: 31237649

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Reviews

    Related information

    • ClinVar
      Related medical variations
    • MeSH
      Related Medical Subject Headings
    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...