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Forum Name: Hypertension

Question: Vasovagal syncope

 weewordy21 - Mon Dec 24, 2007 1:32 pm

A close relative, age 20, has been suffering persistent migraines and fainting (3-5 spells / day) for several months. The blood chemistry workup, head and chest MRI, and CSF pathogen analysis only yielded one abnormality - a patent foramen ovale (PFO).

She is responding with some relief from beta-blockers.
Two questions:
1) If we're looking at vasovagal syncope (autonomous nervous system mediated loss of vascular muscle tone, cave in BP), what medical specialist is best suited
to this type of disease? Does it require a team approach?

2) What additional tests would be advised to sort out a diagnosis?
 Dr. Tamer Fouad - Mon Dec 24, 2007 11:57 pm

User avatar Hello,

I think a cardiologist or a neurologist would be best suited to assess this condition. The only that can judge who would be best consulted would be her primary care physician.

There are many causes of syncope. Vasovagal attacks and postural hypotension are amongst the most common causes include:

-Neurogenic (Epilepsy, Transient Ischemic Attacks)
-Cardiac (Obstructive cardiomyopathy, arrhythmia, ischaemic heart disease, aortic dissection)
-Drug abuse and certain medications.
-Psychogenic (diagnosed by exclusion).

The investigations performed would depend largely on the clinical examination. If it points in a certain direction, the doctor will likely want to confirm the possibility.

Best regards,


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