Vasovagal Syncope (fainting)
A little more than a year ago, a friend told
me his fear of taking the COVID-19 vaccine. Simply put, he faints at the sight
of an injection needle. After a long discussion, he took the vaccine, but did
feel faint. The same thing happened at the second injection of the vaccine. On
meeting him again, I explored further his reaction to needles and discovered he
had the same reaction to blood. He dated the first time he had this type of
reaction to when he was about 16 years of age. It appeared to happen when he
felt stress about taking the SATs for college. He never felt it was a fatal
issue in his life, shrugging it off as the coward in him.
I related to him my "fainting"
experience of getting out of bed quickly, feeling dizzy and dropping to the
floor. I told him that it was diagnosed as orthostatic hypotension. However,
this was not the same as his experience.
A search of the literature indicated that
there are many causes of fainting. The most common appears to be related to
blood pressure failure. Adequate blood pressure is not maintained during
stress.
Some of our readers may remember the picture
of the Palace guard at Buckingham palace fainting while standing under the hot
sun for an extended period of time. Others may know people who faint when they see blood.
The medical name for fainting is syncope. The
type of fainting mentioned above is called "vasovagal syncope".
Rest assured this type of fainting is not fatal and does not mean that
there is some serious underlying issue that should be attended to. Of course there are situations when it could prove
dangerous-while driving or falling and hitting your head on a hard surface.
The literature suggests that there are
currently no reliable ways to prevent this fainting. Researchers are
looking into the use of medication that could prevent some of the
changes in blood pressure that lead to this fainting.
A search of the literature indicated
the following causes of this type of fainting as: "Cause due to
malfunctioning of the nervous system that regulates heart rate and blood
pressure, in response to a stressful or emotional distress"..
"The common triggering factors may
include:
Standing for long
periods of time
In a very hot room
Sight of blood or
facing other stimuli that provoke fear/surprise"
Many people experience a fear of blood,
needles, and doctors. As many as 15% of people experience a dramatic decrease
in blood pressure at the mere sight of blood, even if it is not their own
blood. This is thought to be an evolutionary response, as a drop in blood
pressure decreases the likelihood of loss of blood in the event of a serious
injury. However, a rapid drop in blood pressure can result in fainting, which
is one of the factors responsible for the development of a blood phobia.
Because people can become frightened when they faint, they may learn to fear
fainting in a doctor’s office, and by extension learn to fear blood, needles,
or the doctor’s office itself.
Those at risk for vasovagal attack symptoms
may or may not have existing health problems. It can affect three percent of
the male population and 3.5 percent of females with an increased risk of six
percent in both sexes after the age of 75. While not everyone with the
following risk factors may experience a vasovagal attack, there is a higher
risk with:
Blood collecting in legs
Experiencing a frightful moment
Alcohol use
Exhaustion
Hunger
Extreme stress
Severe pain
Enduring extreme heat
Heat exposure
To repeat: A vasovagal attack is a harmless
event health-wise; however, it can have dangerous consequences such as:
Accident if it occurs while driving
Injury from a fall
Permanent disability from fall injury
Decreased quality of life
There are vasovagal syndrome symptoms that may
alert you to the onset of a fainting spell. If you do faint, it’s usually for a
short period of mere seconds. After fainting, it is recommended to take your
time returning to your feet as you may faint again if done too quickly.
People near you may notice signs of fainting
as well. Their perspective may note dilated pupils or sudden involuntary body
movements.
The question remains, what can a person do
about this issue. The one recommendation that appears to produce favorable
results involves cognitive behavioral therapy. Below, we quote from the
abstract of a study using CBT techniques.
"Cognitive behavioural
therapy as a potential treatment for vasovagal/neurocardiogenic syncope--a
pilot study
J L Newton 1, R A Kenny, C R Baker
Affiliations expand
PMID: 12842647 DOI:
10.1016/s1099-5129(03)00030-8
Vasovagal syncope (VVS) is an exaggerated
tendency to the common faint that affects any age group. Conventional treatment
is non-specific and involves strategies to increase blood pressure. Patients
with VVS are often unable to work or complete education due to actual, or fear
of, syncopal symptoms. Here we present a series of nine patients with VVS whose
symptoms had proved resistant to conventional treatments where intervention
with cognitive behavioural therapy (CBT) led to
significant reductions in reported syncopal episodes and consultations at our
unit. All subjects post-intervention were able to
return to work or schooling. CBT is an effective treatment in those with
difficult to manage VVS. Randomized controlled trials are needed."
For further studies, search the internet with
the words "vasovagal syncope" and "CBT"
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN
SELECTING A NURSING HOME SEE OUR ARTICLE "Selecting
a Nursing Home"
By Harold Rubin, MS, CRC, ABD, Guest Lecturer
posted November 10,2021
http://www.therubins.com
To e-mail: harold.rubin255@gmail.com
or allanrubin4@gmail.com