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Vasovagal syncope — MCCQE Part 1 MCQ

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EasySyncopeVasovagal syncopeMCCQE Part 1

19-year-old woman presents with brief loss of consciousness while standing in a crowded room. She had nausea and warmth before fainting and recovered quickly without confusion. Which of the following is the most appropriate next step?

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Correct answer: D — Diagnose likely vasovagal syncope and provide education after excluding red flags

Diagnose likely vasovagal syncope and provide education after excluding red flags is best because prodrome, standing trigger and rapid recovery support vasovagal syncope. Discharge after a single normal initial test is suboptimal because early cardiac disease can be missed by one isolated result; Arrange routine cardiology review without acute risk stratification is suboptimal because routine referral is too slow for a potentially unstable presentation; Give reassurance because the patient is young or previously well is suboptimal because age alone does not exclude serious cardiovascular disease; Treat only the symptom and omit ECG or biomarker-based assessment is suboptimal because cardiac presentations require objective assessment when suggested clinically. Red flags include exertional syncope, structural heart disease and abnormal ECG.

Reference: CCS Syncope Guideline 2020