Miloš Šimurda, Peter Mitro
Vasovagal syncope as a form of reflex syncope is the most common cause of transient loss of consciousness. The main
objective of the initial evaluation of the patient after syncope is to distinguish vasovagal syncope from syncope of other
etiology (e.g. cardiac syncope). A careful detailed clinical history is sufficient to differentiate these conditions in most
cases. In doubtful cases, a reflex etiology of syncope may be confirmed by the head-up tilt test. In case of syncope of
unknown etiology or suspected arrythmogenic syncope, long-term ECG monitoring using implantable loop recorder
may contribute to the definitive explanation of the cause of syncope. In addition to the traditional lifestyle measures
(patient education, increased fluid and salt intake), isometric counter pressure manoeuvres and home orthostatic training
are currently recommended in the treatment of vasovagal syncope.