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 doctorís office, and by extension learn to fear blood, needles, or the doctorís 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



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, itís 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"



By Harold Rubin, MS, CRC, ABD, Guest Lecturer
posted November 10,2021

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