Vasovagal syncope during driving, working, and exercise

Abstract

Vasovagal syncope may deeply affect common aspects of daily life such as driving, working, and sport. A vasovagal syncope, although benign and characterized by a favorable prognosis, might become dangerous if occurs during driving or in a work setting intrinsically hazardous. In addition, some working activities, such as those requiring a prolonged orthostatic posture or a warm environment, may act as triggers promoting vasovagal syncope. Recently, vasovagal syncope has been recognized as the most frequent cause of loss of consciousness during driving although occurring in sitting position. To promote a safe return to work or driving, patients with vasovagal syncope, should be adequately supported by a multidisciplinary approach, particularly if syncope is recurrent. The relationship between exercise and vasovagal syncope is complex and remains partially unknown. A long-term physical training increases the baroreflex sensitivity and improves the orthostatic tolerance in patients suffering from vasovagal syncope. However, high-intensity exercise may promote vasovagal syncope particularly in trained athletes. Syncope occurring during or immediately after physical exercise should require a workup to rule out the potential presence of a cardiac disease.