14 March 2019 The most common cause of these fainting episodes is reflex syncope (which includes vasovagal syncope). Vasovagal syncope is a fainting episode characterised by intermittent deregulation of the cardiovascular reflexes , responsible for maintaining the circulation of the blood. It arises in the context of strong emotion or prolonged orthostatism (standing position). It is the result of a sudden drop in blood pressure and/or heart rate, with a consequent decrease in the cerebral blood flow and loss of consciousness . One example of this is when soldiers faint on parade. Most fainting episodes are one-off or rare events. However, when patients experience very frequent episodes , fainting can result in depression or physical injury such as fractures or cranial trauma. Tilt test: diagnosing the cause of fainting The tilt test is a diagnostic test used to determine the cause of fainting , which allows reflex syncope to be reproduced in a hospital environment. After successive tilt tests were carried out, it was found there was a tendency for the response to this examination to become normalised . This has led to the proposal of orthostatic training , or tilt training , as a therapeutic measure for vasovagal syncope. Orthostatic training: treating the cause of fainting Orthostatic training consists of undergoing successive sessions on the tilt table until the person is able to r emain standing for 30 minutes without any problems and without significant changes occurring in heart rate and blood pressure. From a practical point of view, people undergoing orthostatic training experience frequent episodes of syncope or vasovagal presyncope , often documented, with a positive tilt test . Initially, the sessions are carried out in a hospital setting , with continuous monitoring of blood pressure and electrocardiogram. The person is placed on a tilting table and remains lying on their back for a few minutes. The table is then tilted for 30 minutes or until problems appear, or until blood pressure and/or heart rate has dropped. Once the 30-minute target has been reached , the person will spend this period of time in a daily orthostatic training session at home . Orthostatic training is an easy, non-invasive treatment without side effects . This can be of great assistance in controlling frequent vasovagal syncope , provided those affected are motivated to complete the training programme. At the hospitals and clinics of the Hospital da Luz network, you can find cardiologists who specialise in the diagnosis and treatment of heart diseases. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network . The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
