# Fainting (vasovagal syncope)

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AS07 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Vasovagal Episode - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK470277/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Fainting (vasovagal syncope) - disease-level clinical article (syncope-vasovagal-full.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
FAINTING (VASOVAGAL SYNCOPE)
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AS07 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Vasovagal Episode - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK470277/
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Fainting (vasovagal syncope) - disease-level clinical article
               (syncope-vasovagal-full.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (2)
    - Fainting while standing points toward a vasovagal cause, while fainting lying down or without
      any warning suggests a cardiac cause  [syncope]
    - History should cover how long the episode lasted, what came before it, what triggered it, and
      what happened afterward
  SIGNS - what you find (2)
    - Exam centers on vital sign abnormalities such as orthostatic hypotension or evidence of
      cardiovascular compromise  [hypotension]
    - Cardiovascular and neurologic exams look for vascular disease, heart failure, or a stroke
      masquerading as a faint  [syncope]
  TESTS (7)
    - History and exam alone reach a diagnosis in up to half of patients presenting with fainting
    - Testing rarely nails down a cause, since most fainting is vasovagal and benign
    - Older patients in the emergency department need routine blood work including hemoglobin and
      electrolytes, plus at minimum an ECG and blood glucose
    - If a cardiac cause is suspected, cardiac enzymes, continuous monitoring, and echocardiography
      are added, with an event monitor for outpatient follow-up of suspected conduction problems
    - Suspected stroke calls for head CT, carotid Doppler, or brain MRI with or without angiography,
      and EEG is added if seizures are suspected
    - A tilt table test is considered for recurrent fainting of unknown cause without heart disease,
      an uncertain vasovagal diagnosis needing life-threatening causes excluded, or to tell reflex
      syncope apart from orthostatic hypotension
    - ECG is the single most useful test yet only identifies a cause in about 5 percent of cases,
      and routine blood tests find one in only about 2 percent
  IF NOT THIS - what else fits (2)
    - Seizures are told apart by an aura, tonic-clonic movements, a longer period of
      unconsciousness, incontinence, tongue biting, and confusion afterward
    - Hypoglycemia can also cause loss of consciousness but usually comes with sweating, shakiness,
      and irritability
  Source  StatPearls "Syncope" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Most fainting in primary care is benign vasovagal syncope managed with reassurance,
            hydration and trigger-avoidance advice; cardiac causes need referral and there is no
            first-line drug a Cairo GP would prescribe. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Most fainting in primary care is benign vasovagal syncope managed with reassurance,
            hydration and trigger-avoidance advice; cardiac causes need referral and there is no
            first-line drug a Cairo GP would prescribe.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Syncope accompanied by concomitant complaints of chest pain, dyspnea, or
            palpitations indicates high risk for cardiac disease.
            RED FLAG - Patients should be instructed not to drive or operate heavy machinery
            following a syncopal episode until completion of workup.
            RED FLAG - Syncope during exertion, a family history of sudden cardiac death, no warning
            symptoms before collapse, injury during the faint, or an abnormal ECG or heart murmur.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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