A vasovagal malaise corresponds to an excessive slowing of the heart rate. This slowing often causes a drop in blood pressure that can result in various symptoms (malaise, sweating, pallor) up to loss of consciousness.

WHAT IS A VAGAL MALSIS?

Generally, a vasovagal malaise occurs in a confined atmosphere, under the effect of heat, significant stress, a phobia (sight of blood, a needle, crowds, etc.) or severe pain. It can also occur in the event of hypoglycemia (drop in blood sugar) or, on the contrary, in the event of a meal that is too rich. Pregnancy and prolonged standing are also circumstances that favor the occurrence of a vasovagal malaise. In some people, it can occur unexpectedly and repeatedly.

HOW TO RECOGNIZE A VAGAL MALSISE?

The diagnosis is generally easy to make, given the circumstances in which the malaise occurs (causes mentioned in the previous paragraph). In some more complex cases, you may be asked to do a test at the hospital: the tilt test, or tilt-test, performed on a tilting table.

CAN I PREDICT ITS OCCURRENCE?

Generally, yes. You normally feel the malaise coming. It is often preceded by yawning, ringing in the ears, paleness, nausea, blurred vision, sweating... You then have time to sit down to avoid falling.

IS THERE ALWAYS LOSS OF CONSCIOUSNESS?

No. Loss of consciousness can occur after the warning symptoms, but it is not systematic.

IS IT SERIOUS?

No. In itself, vasovagal malaise is not serious. If there is loss of consciousness, it generally only lasts a few seconds.

IN THE EVENT OF VAGAL MALESS, WHAT SHOULD YOU DO?

Most often, the malaise passes on its own. However, when you feel the first symptoms, try to sit or lie down with your legs raised (by resting them against a wall or on a chair), head down to allow the blood to better perfuse your brain. You can also splash your face with water. If you witness a loss of consciousness, you must place the unconscious person in the lateral safety position (PLS). Do not try to lift them up.

Lateral safety position in the event of loss of consciousness.

CAN I AVOID RECURRENCES?

Yes. It is recommended to get enough sleep, eat at set times and not eat too large meals. Identify and avoid circumstances that promote or trigger this type of discomfort (confined air, stress, etc.). In the event of frequent recurrences, treatment may be suggested to you by your doctor. Finally, you can wear support stockings or socks.
Although vagal discomfort is generally trivial, it is nevertheless recommended to call for help (18 or 15 from a landline, 112 from a mobile phone) for a diabetic or cardiac person, for an elderly person or if the discomfort seems to last more than a few minutes. Do not try to help a person who is feeling unwell.

Author: DR Robert BRAMI