Syncope – causes, types, diagnostics, first aid, prevention

Proven content

Syncope is a short-term loss of consciousness, sensation, and movement ability due to insufficient oxygenation of the brain associated with ischemia. Pain, anxiety, or the sight of blood can also be another cause of fainting. It is usually accompanied by pale face and cyanosis of the lips.

What is fainting?

Syncope is a condition characterized by a short-term loss of consciousness due to insufficient oxygen delivered to the brain. Fainting usually lasts from a few seconds to several minutes, some describe the feeling as “darkness in front of the eyes”. Fainting is usually preceded by symptoms such as:

1. pale face
2. sinica warg,
3. cold sweat on the forehead and temples.

In most cases, fainting shouldn’t be a concern, especially if there are no other medical conditions behind it. An indication for a medical visit is fainting that occurred more than once a month. In such individuals, cardiac causes that increase the risk of death should be ruled out. The risk of fainting increases sharply in people over the age of 70.

The causes of fainting

There may be times when fainting occurs for no apparent reason. However, it can be caused by many factors, including:

1. strong emotional experiences,
2. fear,
3. low blood pressure,
4. severe pain,
5. dehydration,
6. low blood sugar
7. prolonged stay in a standing position,
8. get up too quickly,
9. practicing physical activity at high temperature,
10. excessive alcohol consumption,
11. taking drugs,
12. overexertion when passing stools,
13. strong cough,
14. seizures
15. fast and shallow breathing.

In addition to the causes mentioned above, medications you are taking may also increase your risk of fainting. Preparations used in the treatment of high blood pressure, as well as antidepressants and antiallergics are of particular importance. In the group of patients particularly at risk of fainting, there are patients with diabetes, arrhythmia, and suffering from anxiety attacks and heart blockages.

Types of syncope

There are several types of syncope:

1. orthostatic syncope: these are repeated episodes in which blood pressure drops while standing. This type of syncope can be caused by circulatory problems;
2. Reflex syncope: In this case, the heart does not supply the brain with enough blood for a short time. The reason for the formation is improper impulse transmission by the reflex arc, which in turn is a fragment of the nervous system. After such a faint, the person is able to function normally, knows what happened and logically answers the questions asked;
3. fainting associated with diseases of the cerebral vessels,
4. fainting due to cardiac arrhythmias.

The most common are reflex syncope, sometimes called neurogenic syncope. This type of syncope is based on a reflex reaction that causes vasodilation or bradycardia. They are most common in young people who are not associated with organic heart disease. Reflex syncope may also occur in elderly people or people with organic heart diseases, e.g. aortic stenosis or after a heart attack. Symptoms of this type of fainting include:

1. no symptoms of organic heart disease;
2. fainting due to an unexpected stimulus due to prolonged standing,
3. fainting when staying in a crowded hot room,
4. fainting when you turn your head or as a result of pressure on the carotid sinus area,
5. fainting occurring during or after a meal.

This type of syncope is diagnosed based on a detailed medical history with the patient, during which the circumstances of the syncope are determined. If the physical examination and ECG result are normal, no further diagnostic tests are required.

Syncope – diagnosis

One-time fainting in a patient in good general condition does not require medical intervention. An indication for a medical visit are situations in which the patient has not experienced such episodes before, but weakens several times. Then it will be necessary to determine the cause of this ailment. The physician should be informed about the circumstances in which the fainting occurred (what was performed, what was the patient’s condition). In addition, information about past illnesses and any medications you are taking, both prescription and over-the-counter, is important. The doctor will order additional tests depending on the result of the medical examination (e.g. blood test for anemia). Testing for heart disease is also often done, for example:

1. EKG test – recording the electrical activity of the heart,
2. heart echo – showing a moving image of the heart,
3. EEG test – measuring the electrical activity of the brain,
4. Holter test – monitoring the heart rhythm using a portable device operating 24 hours a day.

The modern method used to control the work of the heart is ILR arrhythmia recorderwhich is implanted under the skin on the chest. It is smaller than a matchbox and has no wires to connect it to the heart. You should wear such a recorder until you first pass out. The ECG record is read out sequentially using a special head. This makes it possible to determine what led to the fainting.

What else should the doctor be informed about during the interview?

1. tell your doctor about the symptoms that preceded fainting and those that appeared after regaining consciousness (e.g. dizziness, nausea, palpitations, severe anxiety);
2. inform about existing heart disease or Parkinson’s disease;
3. mention also cases of sudden family deaths due to heart disease;
4. Tell your doctor if this is the first time you faint or have had episodes like this in the past.

First aid in case of fainting

In what cases is emergency medical attention necessary during a fainting?

– the patient is not breathing,

– the patient does not regain consciousness for several minutes,

– the patient is pregnant,

– the sick person suffered injuries during a fall and is bleeding,

– the patient suffers from diabetes,

Have chest pain

– the patient’s heart beats irregularly,

– the patient is unable to move the limbs,

– you have trouble speaking or seeing,

– convulsions appeared,

– the patient is not able to control the work of his bladder and intestines.

Treatment of syncope depends on the diagnosis made by the doctor. If no other condition is causing the syncope, treatment is generally not required and the long-term prognosis is good.

First aid

If you pass out, place your head on your back with your head tilted back, placing a pillow or a rolled blanket under your back. You need to provide him with fresh air, unbuttoning pressing parts of clothing, such as: collar, tie, belt. You can sprinkle cold water on your face, rub it with alcohol or put a swab moistened with ammonia on a fainted smell. The rush of blood to the brain makes it easier to lift the legs of a fainted person up.

If you pass out or pass out, do not give anything to drink as you may choke. After regaining consciousness, the patient should remain lying down for some time. Only later can he be served coffee or tea.

IMPORTANT!

1. a patient who faints should not be given food or drink;
2. the patient must not be given their own medications (including nasal drops);
3. do not pour cold water on a fainting person, as this may cause a shock; it is worth wiping his face and neck with a towel dipped in cold water.

Fainting – prevention

Among the methods of preventing syncope due to disorders of the self-regulation of the tension of blood vessels, the following are mentioned:

1. drinking plenty of fluids,
2. increasing the content of electrolytes and salt in the diet,
3. implementation of moderate physical activity (e.g. swimming),
4. sleeping with the head above the body,
5. performing orthostatic training, which involves standing up against a wall (such an exercise should be performed 1-2 times a day for a minimum of 20 minutes).

Important! If you feel weak and you are about to pass out, sit or lie down (your legs should be higher than your head). Ask someone to sit with you for a while.

Fainting – read more about it