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Syncope

syncope

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By Medicover Hospitals / 10 Mar 2021
Home | symptoms | syncope
  • Syncope is a temporary loss of consciousness related to insufficient blood flow to the brain. It is also called fainting or "fainting". This most often happens when the blood pressure is too low (hypotension) and the heart is not pumping enough oxygen to the brain. It can be mild or a symptom of an underlying medical condition.
  • Article Context:

    1. What is Syncope?
    2. Types of Sleep Disorders:
    3. Causes
    4. Diagnosis
    5. Treatment
    6. When to visit a Doctor?
    7. Prevention
    8. FAQ's

    What is Syncope?

  • Syncope, also called fainting, is a loss of consciousness and muscle strength characterized by a rapid onset, short duration, and spontaneous recovery. It is caused by decreased blood flow to the brain, usually due to low blood pressure. Sometimes there are symptoms before unconsciousness such as dizziness, sweating, pale skin, blurred vision, nausea, vomiting, or a feeling of heat. Syncope can also be associated with a brief episode of muscle contraction. When consciousness and muscle strength are not completely lost, it is called presyncope. It is recommended that presyncope be treated in the same way as syncope.
  • Types of Syncope:

  • There are several types of syncope. The type you have depends on the cause of the problem.
  • Vasovagal Syncope (cardio-neurogenic syncope):

  • Vasovagal syncope is the most common type of syncope. It is caused by a sudden drop in blood pressure, which results in decreased blood flow to the brain. When you rise, gravity causes blood to build up in the lower part of your body, underneath your diaphragm. When this happens, the heart and autonomic nervous system (ANS) work to keep your blood pressure stable.
  • Some patients with vasovagal syncope have a condition known as orthostatic hypotension. This condition prevents the blood vessels from getting smaller (as they should) when the patient stands up. This causes blood to pool in the legs and a rapid drop in blood pressure.
  • Situational Syncope:

  • Situational syncope is a type of vasovagal syncope. This only happens in certain situations that affect the nervous system and lead to syncope. Some of these situations are:
    • Dehydration
    • Intense emotional stress
    • Anxiety
    • To fear
    • Pain
    • Hunger
    • Alcohol or drug use
    • Hyperventilation (breathing too much oxygen and getting rid of too muchcarbon dioxide too quickly)
    • Coughing forcefully, turning your neck, or wearing a tight collar (carotid sinus hypersensitivity)
    • Urinating (attenuating syncope)

    Postural Syncope (postural hypotension):

  • Postural syncope is caused by a sudden drop in blood pressure because of a rapid change in position, like from lying down to standing. Certain drugs and dehydration can lead to this condition. Patients with this type of syncope usually have changes in their blood pressure that cause it to drop by at least 20 mmHg (systolic/upper number) and at least 10 mmHg (diastolic / lower number) when standing.
  • Cardiac syncope is caused by a heart or vascular condition that affects blood flow to the brain. These conditions can include an abnormal heart rhythm (arrhythmia), blocked blood flow to the heart because of structural heart disease (the way the heart is formed), blockage of the heart's blood vessels (myocardial ischemia), valve disease, aortic stenosis, blood clot, or heart failure. If you have cardiac syncope, it is important to see a cardiologist for proper treatment.
  • Neurological Syncope:

  • Neurological syncope is caused by a neurological condition such as a seizure, stroke, or transient ischemic attack (TIA). Migraine headaches and normal pressure hydrocephalus are other less common conditions that lead to neurological syncope.
  • Postural Orthostatic Tachycardia Syndrome (POTS):

  • Postural-orthostatic tachycardia syndrome is caused by a very rapid heart rate (tachycardia) that occurs when a person stands after sitting or lying down. The heart rate can accelerate by 30 beats per minute or more. The increase normally occurs within 10 minutes of standing. The condition is most common in women, but it can also occur in men.
  • Unknown Causes of Syncope:

  • Cardiac syncope is caused by a heart or vascular condition that affects blood flow to the brain. These conditions can include an abnormal heart rhythm (arrhythmia), blocked blood flow to the heart because of structural heart disease (the way the heart is formed), blockage of the heart's blood vessels (myocardial ischemia), valve disease, aortic stenosis, blood clot, or heart failure. If you have cardiac syncope, it is important to see a cardiologist for proper treatment.
  • Causes:

  • Syncope is a symptom that can be caused by several causes, ranging from mild conditions to life-threatening. Many non-fatal factors, such as overheating, dehydration, profuse sweating, exhaustion, or the pooling of blood in the legs due to sudden changes in body position, can trigger syncope. It is important to determine the cause of the syncope and the underlying conditions.
  • However, several serious heart conditions, such as bradycardia, tachycardia, or obstruction of blood flow, can also cause syncope.
  • Diagnosis:

  • To diagnose the cause of your fainting, your physician will first take your medical history. They will ask you about your symptoms, what you were doing when you passed out, and if you are taking any medications or have any underlying conditions.
  • They will also perform a physical exam. This may include listening to your heart or taking your blood pressure.
  • Various tests can be used to diagnose the cause of fainting. These tests may include:
    • Electrocardiogram (ECG): An ECG measures the rhythm and electrical activity of your heart using small electrodes. In some cases, you may need to wear a portable ECG machine to monitor your heart's activity over a while.
    • Lab tests: Blood tests can help identify conditions such as diabetes, anemia, or cardiac markers.
    • Tilt table test: During a tilt table test, you will be strapped to a special table. Your heart rate and blood pressure are measured as you go from lying down to upright.
    • Carotid sinus massage: Your doctor will gently massage your carotid artery, located in your neck. They will check to see if symptoms of fainting occur when they do.
    • Stress test: A stress test measures how your heart responds to exercise. Your heart's electrical activity will be monitored by ECG as you exercise.
    • Echocardiogram: An echocardiogram uses sound waves to create a detailed picture of your heart.
    • Electrophysiology: With electrophysiology, small electrodes are threaded through a vein and into your heart to measure the electrical impulses in your heart.
    • Imaging tests: These tests may include a CT scan or MRI, which captures images inside your body. These tests are most often used to examine the blood vessels in your brain when a neurological cause of fainting is suspected.

    Treatment:

  • Treatment will depend on the probable cause of your power failure. You may be asked to keep a journal of your fainting spells, including what you did each time. Most people will only need to see their physician, but you may be referred for further investigation and treatment in a hospital.
  • When to visit a Doctor?

  • Most people who pass out do not need to go to the emergency room, but for a small minority of people who pass out, the brief loss of consciousness can be a sign that more serious and potentially fatal medical events are occurring. looming on the horizon.
  • Prevention:

  • To avoid becoming Syncope or loss of consciousness or fainting:
    • Avoid situations where your blood sugar is too low.
    • Avoid staying in one place for too long without moving, especially if you tend to pass out.
    • Get enough fluids, especially in hot weather.
    • If you feel like you are about to pass out, lie down or sit with your head tilted forward between your knees.
  • If you have a health problem, such as diabetes, always wear a medical alert necklace or bracelet.
  • Frequently Asked Questions:

  • Pre-syncope or near fainting have the same symptoms, but they do not completely lose consciousness. During the fainting episode, the person may lose consciousness and there may be some contractions, which may be mistaken for a seizure. The person may become confused after waking up, but this should be gone within seconds.
  • However, loss of consciousness that lasts longer than a minute or two can be serious. Often, this is a sign of a serious medical problem, such as a seizure, severe blow to the head, concussion, heart attack, diabetic coma, epilepsy, or some other condition.
  • Some people feel light-headed or lightheaded before passing out. Others may have nausea, sweating, blurred vision or tunnel vision, tingling of the lips or fingertips, chest pain, or palpitations. Less often, people suddenly pass out without any warning symptoms.
  • Citations:

  • Syncope - https://www.nejm.org/doi/full/10.1056/nejm200012213432507
  • Syncope - https://europepmc.org/article/med/2189056
  • Syncope - https://www.nejm.org/doi/full/10.1056/nejmoa012407