Vagal syncope is also called reflex syncope. It is an autonomic insufficiency that manifests as an increase in vagal tone, causing a sudden drop in arterial blood pressure, a slowing of the heart rate, and a sudden decrease in cardiac output, resulting in hypoperfusion of the brain, which causes syncope. For example, prolonged standing, or emotional stimulation, or pain, fear, blood, fatigue, blood loss, and medical device examination can all be triggers for syncope. Others include syncope with upright hypotension, which is also associated with autonomic insufficiency. There are also carotid sinus syncope, urinary syncope, swallowing syncope, cough syncope, etc., which are all related to autonomic insufficiency and show increased vagal tone, so they cause syncope as vagal syncope.