Syncope

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Syncope
Fainting

Syncope, or fainting, is a temporary loss of consciousness, lasting for less than 20 seconds. Fainting is caused by a short-term circulatory disorder in the brain, a short interruption of oxygen supply.

Causes

Syncope is a symptom that can be caused by many factors. In order to clarify, all the causes are divided into certain categories:

  •    Reflex syncope. It includes situational (during defecation, coughing, sneezing – this type of syncope usually occurs in older people), neuralgic (due to very severe pain), carotid (caused by stimulating carotid artery receptors, for example, if the shirt collar is too tight) and etc. The following mechanism of this syncope is reflexively impaired blood flow into the brain.
  •    Postural syncope occurs when suddenly standing up from horizontal position. Blood flows into the lower part of the body, causing blood flow insufficiency in the brain and loss of consciousness. However, protective mechanisms turn on very quickly and the loss of consciousness lasts only for a few seconds.
  •    Drug induced syncope. For example, overdosing blood pressure lowering drugs, diuretics, and etc.
  •    Cardiogenic syncope is caused by a heart disease. Loss of consciousness may be influenced by almost all heart diseases: arrhythmias, heart defects, infectious diseases as well as myocardial infarction.
  •    Neurogenic syncope is caused by brain tumors, epilepsy, multiple sclerosis, stroke, TIA and severe migraine.
  •    Metabolic syncope might be caused by metabolic disorders (deficiency of oxygen during respiratory failure, poisoning, low blood glucose and hormone imbalance).
  •    Psychogenic syncope is caused by mental disorders, especially hysteria.
  •    Other causes might include pregnancy, gynecological diseases.

Signs and Symptoms

Obviously, the main symptom is short-term loss of consciousness. But syncope accompanying symptoms are very important as well. For example, postural syncope is usually accompanied by darkening in the eyes, epilepsy may be accompanied by seizures and aura; chest pain and rhythm disturbances might go with heart diseases, hypoglycemia comes with hunger, nervous system diseases are accompanied by neurological symptoms. There are some factors that should also be taken into account: the patient's age, sex, if syncope is recurrent or occurred for the first time, if fainting occurred during standing up or after prolonged standing or sitting, if it is accompanied by pain, also, if the person got injured (during psychogenic syncope the patient does not get injured or dirty, as he/she is "capable of" fainting on a soft object or bed). It is very important to inquire the people who have witnessed syncope: have they noticed any seizures? Did the patient get pale or unintentionally urinated? Be sure to mention your doctor what medicines you are taking, what diseases you have.

Diagnostics

These patients usually see a doctor after the syncope, when they regain consciousness. In order to determine the cause of syncope, almost all available studies are performed. For all patients, without exception, an electrocardiogram is performed. Other tests depend on the supposed cause of syncope: blood tests, computer tomography, cardiac sonography, psychiatrist, gynecologist consultations and others. Women of reproductive age must have a pregnancy test. Under suspicion of drugs or medications, urine toxicological examination can be made.

Treatment

First aid in case of syncope: raise the patient's legs, loosen tight clothes (especially the neck) and sprinkle the face with cold water. If the loss of consciousness lasts longer, it is necessary to evaluate the breathing and heart activity (in this case, it may not syncope). Later the treatment is applied in accordance with the cause.

Prognosis

It depends on the cause of syncope and patient's age. Orthostatic and reflex syncope are usually benign. Other’s prognoses depend on the disease and the efficiency of its treatment.

   

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