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Vasovagal syncope — MCCQE Part 1 MCQ

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ModerateLoss of Consciousness/SyncopeVasovagal syncopeMCCQE Part 1

A 19-year-old woman faints while standing in a crowded warm room after feeling nauseated, sweaty and light-headed. She recovers quickly when supine; ECG is normal and there is no exertional component. Which of the following is the most likely diagnosis?

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Correct answer: D — Vasovagal syncope

Prodrome, prolonged standing, warm environment and rapid recovery are classic vasovagal syncope. Exertional syncope, abnormal ECG, structural heart disease or family history of sudden death would be concerning for cardiac causes. Reassurance, hydration and trigger avoidance are appropriate when red flags are absent.

Reference: Canadian Cardiovascular Society syncope guidance