What is Vasovagal Syncope and Why Does It Suck So Hard

I wrote this on facebook last night:


A vasovagal episode is the official name for the weird thing I have where my heart goes nuts and I sometimes pass out. At least that’s officially what the super fancy specialist at UCSF said — and also that there’s not much to do about it. It just is what it is; some people pass out. Don’t hit your head. Studies say that the only thing that really stops you from passing out is when you feel it coming on you have to do this thing where you sit down and cross your arms and legs, because that forces the blood pressure to rise. So.

Traditionally, this has only happened to me after something big caused my heartrate to skyrocket and then drop, like I would pass out after crashing my bike or I’d have trouble after a really hard race — always after, after sitting up and being ok, after the immediate problem, once I realized I was fine and the whole adrenaline or whatever stopped, then my heart would go nuts and I’d pass out. Fun times. I’m pretty much screwed if I ever get in an actual car crash or have a huge emergency. You can guarantee as soon as I’m safe, I’ll pass out.

The last two times, though, it’s happened during a run with other people. We’d be doing something moderately hard, because of the efforts or the sun or whatever, and we’d stop, stand around and talk for a few minutes, and then suddenly I would be reeling. It happened in July and it happened yesterday after hill repeats with the high school kids. Abruptly, as we were waiting for all the kids to finish, I had to sit down and focus on things not going black and my heart was echoing in my ears and I couldn’t breathe. Needless to say, this is always super fun to explain to people (especially high school kids and especially when you really can’t talk right in the moment).

This time, like the time in July, it took FOREVER for my heartrate to get back to normal. After 5′ or so, I was able to shuffle/jog the mile back to school. But, I still felt not great. And, back at the school, I started to feel disoriented again and like I was going to fall over from the pressure on my head and the light, agh the light, always goes bright and then dark. It took maybe 15-20′ from when it initially started to feel totally ok. This is new. Traditionally, once I passed out I was fine or once it came on it would go away within a minute or two. I even once had to lay down on the track in between intervals to wait for things to stop and then I finished the intervals. That was not happening yesterday.

Yesterday, as is often true when these episodes happen, I was done for the day. I had to bike very, very slowly home. And, then I couldn’t do anything but lay on the couch the rest of the night. I’m still pretty exhausted today — though that may just be from the hill repeats (plus other training) and not from what happened after the hill repeats.

There’s nothing to do. I’ve been to the best specialist doctors and I’ve had all the tests done. There’s no danger to these episodes, they say, even if I did pass out (as long as I don’t get another concussion). It’s just part of my life, whatever. The UCSF doctor did refer me to a specialist cardiologist two years ago, though, because with how my heart speeds up instead of slows down it seems likely I have an arrhythmia too. But, that doctor said the next step is to do this thing where they go up through a vein in my leg to explore my heart and possibly close off (is that the right term?) the arrhythmia. And, I said, ‘yeah, no’ to that.

So, good times.

Do you have episodes like this?

27 thoughts on “What is Vasovagal Syncope and Why Does It Suck So Hard

  1. Well, your Grandma thinks that you should find a very good cardiologist in San Francisco and show him this post. Now I realize that G’mas don’t know anything about anything – but in this instance, it might be good to listen to her. Ya think?

    1. Deedee, this IS what the good cardiologist in San Francisco said. The doctor who gave me all the information about vasovagal and told me about the studies is pretty much the best specialist there is in this. She’s the one who said that it’s not something that there’s ever been found a cure for and it’s not dangerous and she sees it all the time. There’s not some other magical, better doctor that will just be able to make it all go away. That was it.

  2. Oh, well, okay. I’ll go and find something else to worry about. Like the colonoscopy that I have scheduled for Monday!

  3. I do not want to in any way profess to know more than your specialist but my husband was experiencing the same kind of things with fainting and then feeling unwell. He had a faulty heart valve. This was checked by an echocardiogram then also he had endoplasty (the inside view as the camera goes through the artery). Just wanted you to know another example. I do know from experience, it does scare the beejeebees out of family members so I understand grandma in her concern.

    1. Thanks! I’ve had this for like 15 years or so, so we did the echocardiogram before and the docs said everything was fine. They could have messed up, but I’ve had a lot of the standard tests multiple times, so I’m hoping that all checked out.

  4. I sent you a private FB message on this.

    But to answer your question, I nearly passed out a few times in my twenties. I never went to a doctor, though. Once was at swim practice, once was in an aerobics class, and once was after the lat pull down machine. I distinctly remember feeling like my world was turning black. I have no idea how I came out of it. I don’t do the lat pull down machine anymore, and I don’t do step aerobics with weights. I’ve lucked out at swim practice. Well, sometimes when I look up, I get really dizzy, but I don’t know if that’s the same thing.

    Sometimes when I stand up really fast, I feel the world going black. I only learned through Craig’s doc to just squeeze my butt cheeks. But these seem so mild compared to what you’re experiencing. And yes it’s scary. I would imagine it would only increase your anxiety, which wouldn’t help. I hope you find an answer to this and that you can continue to do what you love!

    1. Yeah, I got the facebook notification, but then couldn’t find the message. Stupid facebook.

      It sounds basically the same. The squeezing your buttcheeks thing is pretty much the same.

  5. I once had a suspicious mole removed by a dermatologist, felt fine during the very quick outpatient procedure, but about 5 minutes afterward everything started to spin. I walked out to the reception area and proceeded to crash into the floor. Next thing I remember was smelling salts under my nose and someone asking “Is he still alive?” Fun times indeed!

  6. Scary! I’ve never had that particular issue, but a friend of mine (who is a scary fast runner, and also has an obscenely low resting heart rate) sounds like she has a similar thing. The first time she passed out she was in the hospital for a day because they were trying to figure out what was wrong. Basically it sounded like her condition was linked to the fact that her heart rate & blood pressure were so low that it would occasionally skip a beat (or something?) & that would freak her brain out. It didn’t sound like there was any long-term risk for her either, though, except for getting hurt falling in some way.

  7. A very similar thing just happened to me – I crashed my bike (rain and cycling don’t go together for me, who knew), stood up, checked myself over to ensure I was OK…and then had the telltale headache/blindness, so I sat down and passed out. I didn’t experience the pounding heart you’re describing, but maybe it was going crazy and I wrote it off as stress or something.

  8. VasoVagal Syncope is a bummer. My wife was diagnosed with this condition, but she was given some exercises she could do at home that appear to have resolved the issue. She hasn’t had any symptoms in years. The “exercise” will sound silly, but it has worked for her:

    They call it “Tilt Training.” Basically, she stands leaning against an ironing board at a “slight” angle for a few minutes each day. She stared for only 2-3 minutes, but increased gradually to where she was doing it for 45 minutes. (she would usually do it while watching TV) Any time she felt like she was about to pass out, she would stop. At first she could only last a very short time, but like I said she eventually was able to go a long time and never felt any symptoms. She was also told to increase her fluid intake (water and sports drinks).

    I am not a doctor, so I would talk to a doctor before trying any of these tests, but they worked for her. I should also note that she had a “tilt table test” performed at the hospital before being “prescribed” these exercises.

    Good luck!

  9. Hi there, im a keen cyclist and cycle many miles and ive had these episodes for a year now could this be to do with excessive exercise ???

    1. it’s possible. there’s starting to be some research into the effects of extreme exercise on your hear, but the thing is 1. the sample size for these tests is super tiny, and 2. what constitutes extreme is still decades and decades of the kind of massive mileage done by ultrarunners and adventure racers. and there’s tons of people who have these kinds of episodes and never work out. so it’s more likely that you simply realize it because you exercise. if you had never gone on a bike ride, you might never have known that you were even susceptible to these episodes.

  10. Happened to me the first time two weeks ago, during a 5K race. Started with a crowd of ~350, worked my way towards the front and got to my pace (7:30 -8 minute miles, I’m a 50+ age grouper), and my heart rate skyrocketed, then dropped like a rock. I ended up standing in the woods holding on to a tree to stay up while I tried to figure out what was happening. Then last weekend, a brisk walk back to a hotel room after a dinner party, I got tunnel vision, couldn’t step correctly, started stumbling and collapsed. Now I’m in the medical system as a patient. So far I’ve had I’ve had the stress test, MRI, carotid artery doppler, echocardiogram, and blood work up. Turns out, at 5’9″, 134 lbs and a resting heart rate <50, I'm in really good shape – but that doesn't matter. My normal week included (note the past tense currently) running 4 days per week, 35 minutes each. I have been competing since I started swimming in 7th grade.
    I was so happy to see that other athletes have had this problem. I will learn to live with this new challenge.
    I am new to this whole idea, so any hints to make if work, I am all ears.
    Currently they wont even let me drive!

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