Vasovagal syncope: An overview of pathophysiological mechanisms

Eur J Intern Med. 2023 Jun:112:6-14. doi: 10.1016/j.ejim.2023.03.025. Epub 2023 Apr 6.

Abstract

Syncope is a short-term transient loss of consciousness, characterized by rapid onset and complete spontaneous recovery. According to the 2018 European Society of Cardiology guidelines, three different types of syncope have been identified. However, all forms of syncope share a common final pathophysiological event, global cerebral hypoperfusion, which results from the inability of the circulatory system to maintain blood pressure at the level required to efficiently supply blood to the brain. The vasovagal syncope (VVS) is the most common form of syncope. Although, VVS is generally harmless, its frequent occurrence can negatively affect quality of life and increase the risk of adverse events. The pathophysiological mechanisms underlying VVS remain obscure. The multifaceted nature of VVS presents a veritable challenge to understanding this condition and developing preventative strategies. Thus, the aim of this review was to discuss the factors contributing to the pathogenesis of VVS and provide guidance for future research.

Keywords: Baroreflex; Cerebral hypoperfusion; Gut microbiota; Syncope; Transient loss of consciousness; Vagus nerve; Vasovagal sincope.

Publication types

  • Review

MeSH terms

  • Blood Pressure
  • Cardiology*
  • Humans
  • Quality of Life
  • Syncope / complications
  • Syncope, Vasovagal* / etiology
  • Tilt-Table Test / adverse effects