Exercise-induced vasovagal syncope: limiting the risks.

Abstract

Syncopal episodes in an athlete require a thorough evaluation because some of the possible causes are life-threatening. Two case studies demonstrate the diagnostic work-up, which typically involves electrocardiography, echocardiography, and exercise testing. Tilt-table testing can be used to confirm a diagnosis of vasovagal syncope, but only after structural heart disease has been ruled out. Treatment of vasovagal syncope includes avoiding dehydration and using one or a combination of medications shown to be useful for this condition. Care must be exercised in choosing medications; some are prohibited in organized athletics, and some can hurt performance.