Transient loss of consciousness due to cerebral hypoperfusion, characterized by rapid onset, short duration, and spontaneous complete recovery

Reflex syncope

• Involves neural reflexes
• Vagal stimulation decreases HR which decreases CO AND/OR
• Depression of sympathetic activity to blood vessels - vasodilation, which decreases SVR, venous return, SV and CO
• Decrease in CO and SVR → decreased MAP → syncope

Vasovagal syncope

• Most common
• Faint triggered by emotional distress or orthostatic stress
• Associated with pallor, sweating and nausea
• Can be averted through manoevers to increase venous return e.g. horizonal gravity neutralisation position

Management

• Education
• Reassurance
• Avoidance of triggers
• Adequate hydration

Situational reflex syncope

• Faint during/immediately after a specific trigger e.g. cough

Management

• Treat cause if possible