Syncope

bradycardia fainting

What is syncope?

Syncope is a medical term used to describe a person fainting. It usually happens when there isn’t enough blood flow to the brain. This occurs when the blood pressure is too low and the brain doesn’t receive enough oxygen. Syncope is usually a symptom of an underlying medical problem.

Syncope is a very common condition. 3.5% women and 3% of men have syncope at some point in their life. It is more prevalent in older adults, with 6% of people over the age of 75 being affected by this condition.

How does syncope occur?

bradycardia faintingTo understand how fainting occurs, it is important to understand how the brain functions.

The brain requires constant blood flow for it to get oxygen and glucose. For a person to be awake, the reticular activating system, an area located in the brain stem, needs to be turned on. Also, at least one of the hemispheres in the brain needs to be active. Fainting occurs when the reticular activating system loses its blood supply or both the hemispheres of the brain are inactive due to them being deprived of oxygen or glucose.

Types of Syncope

There are several types of syncope and it usually depends on the underlying problem. Some of the most common ones are

Vasovagal syncope

This is the most common type of syncope. This happens when the body overreacts to certain triggers, such as shock, the sight of blood or emotional distress. The part of the nervous system that regulates heart rate and blood pressure malfunctions in response to these triggers.

This causes a sudden drop in heart rate and blood pressure, which in turn leads to reduced blood flow in the brain. This results in a person briefly losing consciousness (less than a minute).  Some of the symptoms of vasovagal syncope include

  • Pale skin
  • Lightheadedness
  • Tunnel vision
  • Nausea
  • Feeling warm
  • Cold, clammy sweat
  • Yawning
  • Blurred vision

Vasovagal syncope is generally harmless and does not require any treatment. However, your doctor may recommend you more test to rule out other causes such as heart problems.

Situational syncope

stress, anxiety, depressionThis is a type of vasovagal syncope that occurs only in certain situations like

  • Having blood drawn
  • Straining while urinating or defecating
  • Coughing
  • Dehydration
  • Intense emotional stress
  • Anxiety
  • Fear
  • Pain
  • Hunger
  • Excessive use of alcohol or drugs
  • Hyperventilation (breathing too fast)

When faced with these triggers, the person feels nauseated, sweaty, and weak just before losing consciousness. Situational syncope happens due to something known as the vasovagal reaction, a reflex of the involuntary nervous system. The vasovagal reaction prompts the heart to slow down and the blood vessels in the legs to widen. As a result, less blood is pumped and most of the circulating blood is directed towards the legs. When the brain is deprived of oxygen, fainting occurs.

Postural syncope

Also known as postural hypotension, this type of syncope occurs when there is a drop in blood pressure due to a sudden change in position of the body (for example, when you suddenly get up from a lying position).

Postural syncope is characterized by a decrease in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg when a person stands up. Depending on the time taken for the blood pressure to drop, postural hypotension can be divided into three types

  • Vasovagal orthostatic hypotension: This happens almost suddenly
  • Classic orthostatic hypotension: This type happens within three minutes
  • Delayed orthostatic hypotension: This type happens gradually.

Postural syncope occurs due to delayed or absent constriction of the blood vessels of the lower body. Constriction in the lower blood vessels is required to maintain a normal blood pressure when the position of the body is changed to standing. When the constriction is delayed or absent, the blood in the legs takes a longer time to reach the heart and this decreases the blood flow to the brain. Postural syncope can also make you feel dizzy or lightheaded.

Neurologic syncope

This type of syncope happens due to a condition such as

  • Seizure
  • Stroke
  • Transient ischemic attack (TIA)

Other less common conditions that lead to neurologic syncope include

  • Migraines
  • Normal-pressure hydrocephalus

Causes

Syncope is often triggered by the vagus nerve, which connects the digestive system to the brain. Its main function is to regulate the blood flow to the abdominal region. When a person eats food, the vagus nerve directs more blood into the stomach and intestine. However, sometimes the vagus nerves can also trigger syncope by directing too much blood away from the brain. This can happen due to the following reasons.

Panic attack

Panic attacks are a common cause of syncope. During a panic attack, a person starts to hyperventilate (breathing faster and more deeply). When this happens, the body takes in too much oxygen and gets rid of too much carbon dioxide. When the carbon dioxide levels in the body become low, the blood vessels start to constrict and this leads to the reduced blood supply to the brain.

Dehydration

Dehydration is a condition that happens when the amount of fluids lost by the body exceeds the amount that is taken in. This may happen due to vomiting, diarrhea or increased urination due to an infection.  When dehydration occurs, the vagus nerve is stimulated and this leads to syncope.

Pain

Pain can stimulate the vagus nerve and is a common cause of fainting. Syncope generally occurs when the body does not feel it can tolerate pain. This is a defense mechanism that the body uses in case of intolerable pain.  Syncope resulting from pain differs from person to person due to each individual having his/her own level of pain tolerance.

Emotional distress

Syncope also happens when people are under extreme emotional distress. For example, a person may faint if he/she gets some upsetting news like the death of a loved one. It may also happen in the presence of certain triggers like medical students fainting while observing their first autopsy or surgery. The vagus nerve is stimulated by certain hormones which are released when the body is under emotional distress.

Shock

Shock is a serious state that results due to decreased blood flow to the brain and other important organs. Shock may result due to

  • Loss of blood
  • Severe allergy
  • Severe infection
  • Dehydration
  • Poisoning
  • Burns

Shock usually leads to unconsciousness due to the disruption in the blood flow to the brain.

Alcohol abuse

Many people faint after drinking a lot of alcohol. A rapid rise in the alcohol levels in the blood prompts the vagus nerve to induce syncope so not the intake is stopped. Fainting after drinking alcohol is a sign of serious intoxication. Alcohol also makes a person dehydrated (due to too much urination), dilates blood vessels and decreases blood pressure. All these results in syncope.

Anemia

Anemia is a condition that is used to describe a condition in which a person doesn’t have enough healthy red blood cells. There are several types of anemia. These are

  • Iron deficiency anemia.
  • Vitamin deficiency anemia
  • Anemia of chronic disease
  • Aplastic anemia
  • Anemias associated with bone marrow disease.
  • Hemolytic anemias.
  • Sickle cell anemia

When the anemia is severe, fainting occurs as they are not enough red blood cells to deliver oxygen to the brain.

Drugs

Illegal drugs and prescribed drugs can also lead to syncope due to dehydration or drops in blood pressure. Here are a few drugs that may make you faint.

  • Nitrates: These drugs lower blood pressure and this results in you fainting
  • Diuretics: These drugs make you urinate more and that can lead to dehydration, which in turn may lead to fainting.
  • Opiates: These drugs work by lower blood pressure and slowing breathing
  • Heart drugs: These also decrease blood pressure
  • High blood pressure drugs: These also lower blood pressure

Abnormal Heart Beat

The heart plays a vital role in maintaining blood pressure. The heart is the organ that is responsible for forcing blood through the arteries and veins. If the heart beats abnormally, it is unable to maintain the required blood pressure. This results in reduced blood flow to the brain, which in turns results in fainting.

Symptoms

The most common symptom of syncope is dizziness just before fainting. However, it may also have the following symptoms

  • Feeling lightheaded
  • Falling
  • drowsiness or grogginess
  • Weakness after eating or exercising
  • unsteadiness or weakness when standing
  • Changes in vision
  • Headaches

People often experience “premonitory symptoms” before a spell of syncope. These may include

  • Heart palpitations (irregular heartbeats)
  • Lightheaded
  • Nausea

Diagnosis

Although most cases of syncope are harmless, you should see a doctor if you faint without any reason. You may be referred to a syncope specialist for a complete evaluation

If you have syncope, you should see your doctor, who can refer you to a syncope specialist for a complete evaluation. He/she will begin by doing a physical exam after carefully evaluating your medical history. You will then be asked questions about your syncope episode or episodes.

You may need tests, including electrophysiology studies, autonomic nervous system testing, neurological evaluation, and computed tomography (CT) scan. Vestibular function testing may be done to rule out problems in the inner ear. If you need any additional testing, your doctor will explain them and why they are needed.

You may then have to do the following tests

  • Tilt Test: This test is done to determine the amount of blood in your body, and the flow in different positions. During this test, you will be put in a bed that tilts vertically. Your oxygen level, heart rate, electrical impulses in the heart and blood pressure is then recorded as you’re tiltedat different angles.
  • Blood tests: This is done to check for anemia or any other blood abnormalities.
  • Electrocardiogram (EKG or ECG): This test is done to check the electrical activity of the heart. During this test, electrodes are attached to the skin near your heart. These record the electrical activity of the heart.
  • Exercise stress test: This test involves a person walking on a treadmill or riding a static bike while the heart is monitored.
  • Ambulatory monitor: You will wear a monitor that uses electrodes to record information about your heart’s rate and rhythm.
  • Echocardiogram: This test uses sound waves to make a pictorial representation of the heart. During the test, a transducer (a wand-like substance) is kept near your chest. This device produces sound waves that are directed towards your heart. These sound waves bounce off your heart to produce an image that is processed electronically. This test can determine the heart is functioning normally.
  • Blood volume determination: This is a test done to see the amount of blood in your body based on your gender, height, and weight.
  • Hemodynamic testing: This test is done to determine the blood flow and the pressure inside your blood vessels.
  • Autonomic reflex testing: This is a series of tests that are done to monitor blood pressure, blood flow, heart rate, skin temperature and sweating in response to certain stimuli.

Treatment

Treatment will usually depend on treating the underlying disease that caused the syncope. However, you may be asked to follow these measures.

  • Make changes to certain medications that you are currently on
  • Improve blood circulation by wearing garments or compression stockings
  • Change your diet
  • Be careful while changing the position of the body
  • Elevate your head while sleeping
  • Avoid certain triggers that induce a syncope episode
  • Do biofeedback training to slow down the fast heart rate
  • Undergo treatment for heart problems
  • Get a pacemaker implanted to keep your heart rate steady

Presyncope

Presyncope is the term to refer to a state when a person almost loses consciousness, usually due to reduced flow of blood to the brain. Some of the symptoms of presyncope include

  • Dizziness
  • Lightheadedness
  • Vertigo
  • Blurry or narrowed vision
  • Nausea
  • Vomiting
  • Headache
  • Sweating
  • Heart palpitations
  • General abdominal discomfort
  • Confusion or disorientation
  • Slurred speech

Presyncope is not that dangerous as the person doesn’t actually lose consciousness and the likelihood of injury is reduced. However, you should immediately see the doctor as presyncope may also be a sign of an underlying health condition.

How to help a person who has fainted?

You can help a person who has fainted by following these measures

  • If the person has not fainted but is showing the signs of syncope then help him/her lie down
  • Raise his/her legs by putting lifting their ankles to induce the blood flow back to the brain.
  • Try to wake the person up by tapping them or calling their name. You may also sprinkle some water on their face.
  • After he/she wakes up to tell them to lie down for at least 15-20 minutes.

Prevention

Although syncope is something that cannot be prevented, you can take certain measures to prevent it from happening.

  • If your fainting is caused by some triggers (for example, the sight of blood) try to avoid it.
  • If you feel lightheaded while standing up, move slowly while changing the position of your body.

Facts

  • People of any age can faint, but syncope in older adults is usually an indication of a serious underlying cause.
  • According to stats, 1 in 3 people experience syncope

Facts

  • Fainting was called swooning in England during the Victorian era
  • Well-to-do women in England often had something called a “fainting room” in the Victorian era

Facts

  • Popular to contrary belief, a blow to the head doesn’t necessary result in fainting

Related Conditions

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Dos and Don'ts

Dos
  • Always loosen the victim’s clothing, especially if it is tight
  • Apply a moist towel to the victim’s face and neck
  • Remove the victim’s glasses (if he/she wears one)
Don'ts
  • Slap or shake someone who’s just fainted
  • Try to give the victim any food or drink
  • Don’t try to lift the victim
  • Allow the victim to get up right away after he/she recovers

 

 

 

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EMA antibodies
Endomysial Antibodies (EMA) Test EMA test is an investigative blood examination to locate the presence of certain antibodies, called Endomysial antibodies or…
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
Pumpkin Seeds: Why pumpkins are more than just for pies! Pumpkins have been long associated with Halloween carvings and delicious pies. But did you know that pumpkin seeds…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
ketoacidosis diabetes
HB1Ac Test HB1Ac test is an important blood test that is used to measure the levels of glycated hemoglobin in…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
hepatitis B envelope antigen
Hepatitis B Envelope Antigen (HBeAg) The HBeAg or hepatitis B envelope antigen test is a screening test used to diagnose the onset of…
beta 2 glycoprotein 1 IgG
Beta 2 Glycoprotein 1 IgG Beta 2 glycoprotein 1 antibody test involves detecting and measuring the presence of the IgG class of beta…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
macadamia nuts in food
Proven health benefits and nutrition of macadamia nuts Know all about scientific, amazing health benefits of macadamia nuts, its nutrition, recipes, how to consume, price and…
macadamia nuts in food
Proven health benefits and nutrition of macadamia nuts Know all about scientific, amazing health benefits of macadamia nuts, its nutrition, recipes, how to consume, price and…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Sputum test Sputum test is a commonly used diagnostic tool that is used to examine the presence of pathogens in…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…