Syncope

bradycardia fainting

Last Updated December 20th, 2021

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.

 

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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Stye : The best natural home remedies to ease the pain Styes developing inside the eyelid tend to be more painful whereas external styes are less painful and ooze…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
copper serum test
Copper Serum Test Copper serum test checks for abnormal levels of copper in the body. Both high and low levels of…
Tachycardia heart
Cardiac Profile Cardiac profile is panel of blood tests performed to check cholesterol level and other heart disease markers to…
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…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Garlic health benefits cloves
Garlic: Nature’s white pill as an effective home remedy What are the secrets hidden in these tiny white pills? Find out the immense health benefits of using…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
free thyroxine ft4
Free thyroxine test (FT4) The FT4 or free thyroxine test is used to detect the level of free thyroxine of FT4 thyroid…
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…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
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…
hsv igg test
Herpes Simplex Virus I (HSV)-IgG Test Herpes Simplex Virus I (HSV)-IgG is used to detect the presence of the herpes virus so that the…
hlab27 test
HLA-B27 test The HLA-B27 is a blood test that is used to determine the level of a particular protein called…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
top 10 deadliest diseases
What are the top 10 deadliest diseases and what is causing them? What are the largest killers of human lives across the globe? Which diseases are the most fatal ones?…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
vital organ diseases
Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
carbamazepine
Carbamazepine / Tegretol test The carbamazepine is a drug that is used to treat epilepsy and the carbamazepine test is performed to…
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…
Chondroitin spine health
9 amazing ways chondroitin can help you bounce back to health Chondroitin is naturally found in meat, especially in the connective tissues of animals. Chondroitin works by reducing the…
Sharpen your brain with these top brain-friendly foods! Did you know your diet could decide how razor sharp your memory is? Or that what you eat…
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…
smelling-salts-benefits
The actual science behind smelling salts and how it helps in injury recovery Most smelling salts are a mixture of ammonium carbonate and some perfumes which are sniffed by an individual…
Maltitol: Things you must know about this artificial sweetener Sugar alcohols are produced by fruits and vegetables. Maltitol is an artificially produced sugar alcohol and is used…
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…
blood elements analysis
Vitamin Profile Your doctor will recommend you undergo the vitamin profile test if you are showing signs of either vitamin…
CT-scan-machine
CT – Computed Tomography Scan CT scan or computed tomography scan is an diagnostic imaging technique where cross-sectional images of body are obtained…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
Sputum test Sputum test is a commonly used diagnostic tool that is used to examine the presence of pathogens in…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
ASTtest-liver
AST- Aspartate Aminotransferase Test AST test is a blood test that is used to measure the level of a particular liver enzyme…
lipoprotein A
Lipoprotein (A) Test Lipoprotein (A) test is used to measure and monitor the levels of LDL(Low-Density Lipoprotein) in the bloodstream in…
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…
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…
PREGNANCY
Pregnancy During pregnancy, the body undergoes a number of biological and physical changes to accommodate and provide for the…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
Gua sha: Scraping away layers of pain with this ancient healing tool Gua sha is an ancient oriental healing method which focuses on scraping the body with specific tools to…
Helicobacter pylori IGA
Helicobacter Pylori – IgA Test The H.pylori IgA test is a blood test used to identify the level of IgA antigen in the…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
Threatened abortion
A few facts about threatened abortion A threatened miscarriage indicates an early pregnancy loss. Look out for symptoms like bleeding, vaginal discharge, and pain.
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…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
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?…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
fitness routine fun
10 fantastic ways to make your fitness routine more fun! Are you too bored to exercise? Do you avoid gym cause it's too monotonous? Looking for fun and…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
labiaplasty
Labiaplasty Labiaplasty is a surgical procedure to modify the labia minora and the labia majora. Learn about who can…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
castor oil hair
Castor oil : A vitamin-rich oil for shiny locks and healthy bowels Castor oil bestows unlimited benefits, whether you use it for your hair or skin. But did you know…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
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…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
Muscle relaxers: Think twice before popping prescription drugs for muscle pain The market is brimming with OTC muscle relaxers. But these come with a host side-effects. Find out the…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
free testosterone test
Free testosterone Free Testosterone Test measures and monitors the level of the free testosterone in the blood. Less than 4%…
toxo gondii igm test
Toxo Gondii-IgM Test The toxo gondii IgM test is a blood test that tells the presence or absence of toxoplasmosis IgM…
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…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Bloodtestalbumin
Albumin Test Albumin test or blood serum test is a liver function test that measures the amount of the protein…
Hymenoplasty
Hymenoplasty Read on to find out all about hymenoplasty, the procedure, post-surgery care, the risks, and the benefits.
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…

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