• Neurocardiogenic syncope has been called the “common faint” and is also known as “vasovagal syncope”
• It can occur when a person rises to a standing position from a lying or sitting

• 25% to 40% of fainting disorders are due to neurocardiogenic syncope

• Neurocardiogenic syncope often affects young, healthy individuals who have no history of heart disease or neurological problems
• Most common cause of fainting in young people
• Some adolescents have frequent fainting spells and may outgrow this in the mid-twenties

• It is thought to result from a “miscommunication” between the brain and the heart and may be a result of an overactive normal reflex
• When we stand up, the brain sends signals to the blood vessels in the legs to dilate, or relax
• When the blood vessels in the lower extremities relax, blood may pool in the legs, which can reduce the amount of blood returning to the heart
• If the heart does not pump enough blood to supply the brain’s need for oxygen, lightheadedness can occur

More about what happens in neurocardiogenic syncope::

• Sometimes, the heart tries to raise the blood pressure by increasing the force of contractions and the rate of the heartbeat, which can make the problem worse

• As the heart beats stronger and faster, a “faulty” message is sent from the heart to the brain saying that  the heart’s pumping chambers are filled with blood and that the blood pressure is too high
• In fact, the heart’s chambers are not full and the blood pressure is too low
• When the brain receives this “faulty” message, it slows the heartbeat even more and relaxes the blood vessels even more
• Less blood is pumped to the brain and the risk of fainting increases

• Conservative measures to treat neurocardiogenic syncope include:

   

• Increase fluid intake

   

• Increase salt intake; avoid excess salt if blood pressure becomes elevated

   

• Lie down and elevate legs if an episode of lightheadedness occurs; do not attempt to “walk it off”

   

• Medications to treat this include:

   

• Beta blockers

   

• Salt tablets

   

• SSRI medications, such as paroxetine (Paxil^®), sertraline (Zoloft^®), fluoxetine (Prozac^®) to name a few

   

• Orthostatic syncope is the inability to maintain normal blood pressure while standing

   

• Due to disorders of the autonomic nervous system (ANS), which manages most of our automatic bodily functions;  problems with this mechanism is called dysautonomia
• May occur in healthy people as a result of standing for long periods, exercise or overeating

   

• Conditions such as diabetes, Parkinson’s Disease, multiple sclerosis or conditions that cause nerve damage may contribute to this problem

   

• Metabolic syncope can occur in situations of hypoglycemia (low blood sugar) or hyperventilation (rapid, shallow breathing)

   

• Any condition that causes low blood pressure
• Loss of blood volume caused by bleeding, diarrhea or vomiting
• Eating a large meal or drinking alcohol
• Vigorous exercise without re-hydration
• Medications, such as diuretics, that have led to, excessive fluid loss
• Menstruation
• “Hypersensitive” autonomic nervous system, in response to triggers, such as sneezing, coughing, urination or having a bowel movement
• Emotional or stressful situations
• Headache
• Illness or trauma