Cardiovascular · UKMLA & AKT

Vasovagal syncope

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise vasovagal syncope — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Three phases - prodrome, brief LOC (<1 min), rapid full recovery. Diagnosis is clinical.
  • Prodrome (seconds to minutes before): warmth/flushing, nausea, pallor, diaphoresis, lightheadedness, greying/darkening vision, whooshing sound in ears
  • LOC: brief (<1 min), limp and pale; ~10% have brief myoclonic jerks ('convulsive syncope') - can mimic seizure
  • Recovery: rapid and complete; no post-ictal confusion, no focal deficit, orientation returns almost immediately

The key discriminator from tonic-clonic seizure is the post-ictal state. After a faint, recovery is immediate. Prolonged confusion after LOC = seizure until proved otherwise.

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