Syncope (pronounced “sin ko pea”), also called fainting or “passing out”, is a frequent symptom causing individuals to seek medical attention. It can be benign, or a symptom of an underlying medical condition that requires further evaluation.
What is syncope?
Syncope is a temporary loss of consciousness usually related to insufficient blood flow to the brain. It is also referred to as a blackout. It most often occurs when blood pressure is too low (hypotension) and the heart does not pump enough oxygen to the brain.
How common is syncope?
Syncope is a common condition. It affects 3% of men and 3.5% of women at some point in life. Syncope is more common as you get older – and affects up to 6% of people over age 75. The condition can occur at any age, and happens in people with and without other medical problems.
What are some causes of syncope?
Syncope is a symptom that can be due to several causes, ranging from benign to life-threatening conditions such as overheating, dehydration, heavy sweating, exhaustion or the pooling of blood in the legs due to sudden changes in body position. Syncope can also be the symptom of life-threatening conditions such as serious heart conditions like bradycardia, tachycardia or blood flow obstruction.
Vasovagal syncope (also called cardio-neurogenic syncope)
One of the most common types of syncope is called vasovagal syncope. It is caused by a sudden drop in blood pressure which causes a drop in blood flow to the brain. When you stand up, gravity causes blood to settle in the lower part of your body – below your diaphragm. When that happens, the heart and autonomic nervous system (ANS) work to keep your blood pressure stable.
Some patients with vasovagal syncope have a condition called orthostatic hypotension. This condition keeps the blood vessels from getting smaller (as they should) when the patient stands. This causes blood to collect in the legs and leads to a quick drop in blood pressure.
Neurologic syncope
Neurologic syncope is another type of syncope. It is caused by a neurological condition such as seizure, stroke or transient ischemic attack (TIA).
Syncope and pregnancy
Some females suffer from syncope when they are pregnant. If you having frequent syncope attacks, and you have missed your menstrual period, you should see your obstetrician/gynaecologist or some other healthcare provider.
Unknown causes of syncope
The cause of syncope is unknown in about one-third of all patients. It should be pointed out that an increased risk of syncope is a side effect of some medications. If you are having syncope please inform your doctor of all medications you are taking – including over the counter medications.
`How do you know you are having syncope?
Many times, patients feel an episode of syncope coming on. They have what are called “premonitory symptoms,” such as feeling lightheaded, nauseous, and heart palpitations (irregular heartbeats that feel like “fluttering” in the chest). If you have syncope, you will likely be able to keep from fainting if you sit or lie down and put your legs up if you feel these symptoms.
Syncope can be a sign of a more serious condition. So it is important to seek medical advice as soon as possible – and get treatment right away after you have an episode of syncope. Most patients can prevent problems with syncope once they get an accurate diagnosis and proper treatment.
Things you can do to prevent fainting
If you feel like you are about to faint, try to:
• lie down with your legs raised. If you cannot do this then sit with your head lowered between your knees
• drink some water
• eat something
• take some deep breaths
If you are with someone who has fainted, try to keep calm.
If you can, lay them on their back and raise their legs.
Usually, the person who has fainted will wake up within 20 seconds.
If someone does not wake up after one minute, or has a fit/seizure, or has severely hurt themselves, call 911 immediately or seek urgent medical attention.hey:
Diagnosis and treatment
If you have syncope, you should see your doctor who will evaluate you and treat you, or refer you to a syncope specialist for a complete evaluation. A detailed history and physical examination are required – as well as a series of investigations. Your treatment options will depend on what is causing your syncope, and the results of your evaluation and testing. The goal of treatment is to keep you from having episodes of syncope. Your doctor and other members of your healthcare team will develop a treatment plan that is right for you – and talk to you about your treatment options. In some countries if you have frequent syncope attacks these might prevent you from getting a driving license until they are treated.
With the proper diagnosis and treatment, syncope can be managed and controlled. If you have had an episode of syncope, there is about a 30% chance you will have another episode. Your risk of another episode, and how the condition affects you, depends on several factors – including the cause and your age, gender and other medical problems you have. If you have questions about your risks, please talk to your doctor.
Conclusion
Syncope is the medical term for fainting or passing out. It is caused by a temporary drop in the amount of blood that flows to the brain. There are many causes of syncope. Some are not serious, but other causes can be very serious and could be life-threatening. Individuals should not ignore episodes of syncope. If you suffer from syncope, or know someone who has syncope, seek medical attention for a full evaluation. There are various treatment options now available for successfully treating episodes of syncope – once the underlying cause is determined.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
