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Syncope, also referred to as fainting, is a medical term which describes a short loss of consciousness with inability to maintain posture, that is characterized by spontaneous recovery after the episode. It occurs as a result of a suddenly decreased blood flow, which is afterwards limiting the blood supply to the brain. In vast majority of the incidents, such episodes do not cause any harm to the patient, however it is possible to get injured during collapsing. In addition, fainting might by preceded by a set of prodromal symptoms, such as excessive sweating, skin paleness or vomiting. It is estimated, that fainting is responsible for up to 6 cases per 1000 people every year.
Syncope classification and possible causes
There are 3 major categories of fainting, that are based on its origin:
- Reflex fainting, also referred to as neurally mediated or vasovagal syncope – it is the most common type of the disorder, which occurs in response to a trigger. Those triggers may include, for instance, events that are stressful, fearful or painful. Furthermore, the sight of blood or corpses and standing up instantly after long idleness may trigger fainting as well. Other less common causes include lack of sleep, dehydration, starvation and heavy exercises.
- Fainting associated with orthostatic hypotension (postural hypotension) – it occurs when the blood pressure drops down suddenly due to standing up from either sitting or lying position. It can be caused by diseases, such as Addison’s disease, diabetes, multiple system atrophy, Parkinson’s disease or dehydration, as well as by administration of certain drugs or medications, like alcohol, diuretics, phenothiazine and antidepressants. This type of fainting is frequently preceded by the presyncope, a state during which vertigo, muscular weakness and blurred vision appears.
- Cardiovascular related – presumably the least common type, which is responsible for approximately 10% of all incidents. Nevertheless, it is the most dangerous one, since it usually indicates serious, or even life threatening disorders. The most common cause of those episodes is a cardiac arrhythmia, either due to bradycardia, characterized by slow heart rate, or tachycardia, which is an increased heart rate. Other possible causes include aortic or mitral valve stenosis, myocardial infarction, Adams–Stokes syndrome and aortic dissection.
Associated symptoms and signs
There are several symptoms and signs that are indicating incoming syncope. Although some of the incidents occur suddenly, the patient may have the opportunity to notice the set of prodromal symptoms. Those symptoms include, for instance:
- Excessive sweating
- Skin paleness
- Blurred or narrowed field of vision
- Muscle weakness
It is worth remembering, that observers can also recognize the fainting. Noticeable features include weak pulse, pupil dilation and involuntary twitchy movement.
For the mild cases, the use of complex diagnostic tools is not required. A specialist will investigate a patient’s medical history and perform simple physical examinations, which may reveal events triggering the fainting. However, if the cardiovascular system is involved, the healthcare provider will have to run certain tests, such as electrocardiogram, cardiac stress test, echocardiogram or complete blood count.
After the episode of syncope, the recovery frequently takes less than one minute. Although it is highly recommended to not stand up immediately after regaining the consciousness. The victim should lie or sit for at least 15 minutes, in order to avoid consecutive syncope. In case of reflex fainting, a specialist may be able to identify triggering events and instruct how to successfully avoid them. Nevertheless, when fainting is caused by an underlying disease, the treatment course needs to be adjusted specifically.