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Psychological stressors include stirring emotional news or witnessing a distressing accident <cite>Lewis</cite>,<cite>Engel44</cite>, unexpected pain or threat <cite>Lewis</cite>,<cite>Greenfield</cite>. Unpleasant smells may trigger vasovagal syncope <cite>Engel47</cite>,<cite>Ganzeboom</cite>. During blood drawing, vaccination <cite>Braun</cite> or instrumentation, pain of the procedure may contribute to vasovagal syncope. Sharp pain is reported to be an important factor during arterial blood sampling <cite>Rushmer</cite>. However, in a patient with blood phobia just thinking or talking about blood drawing may elicit a common faint <cite>Dijk01</cite>.    

Syncope after exercise is often neurally mediated, i.e. post-exercise vasovagal syncope. This condition is typically diagnosed in young fit, furthermore healthy young patients. Foremost, the diagnostic workup of all patients presenting with exercise-related syncope is aimed at excluding dangerous cardiac conditions and includes echocardiography and exercise testing <cite>Krediet04b</cite>.  

Characteristically, syncope may occur while the individual is standing motionless during the first five to ten minutes after exercise <cite>Bjurstedt</cite>. Especially athletes in the (ultra) endurance sports are at risk for post exercise vasovagal syncope e.g. after marathon swimming (Finlay et al., 1995) or marathon running (Tsutsumi & Hara, 1979;Holtzhausen & Noakes, 1995;Holtzhausen & Noakes, 1997).

Vasovagal syncope after routine treadmill testing is rare (estimated 0,2% (Schlesinger, 1973)). However, when treadmill testing is immediately followed by passive head-up tilt testing, this percentage can increase up to 50-70% (Bjurstedt et al., 1983). Vasovagal syncope after exercise is considered to be a benign occurrence (Krediet et al., 2004b).