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What is Syncope or Fainting?

Syncope or fainting is a temporary loss of consciousness and muscle strength. It is caused due to a sudden decrease in blood supply to the brain. It can last for variable amount of time but it recovers spontaneously. Syncope is very often associated as a symptom of an underlying heart problem although it can have multiple other causes.

Understanding Fainting:

Syncope is a fainting spell in which there is a transient loss of consciousness. Depending on the duration of syncope, a person can experience dizziness, unconsciousness and convulsions. The maximum duration of syncope is 30 minutes however; it is usually seen to last for a few seconds. The brain is very sensitive to the blood supply and hampering it for even a small amount of time can produce effects. Syncope is one such effect and it can be caused due to cardiac causes, drugs, etc.

What are the causes and risk factors for Fainting?

1. Cardiac causes

    • Abnormal electrical activity in the heart like heart block
    • Extreme slow or fast heart rate (bradycardia and tachycardia respectively)
    • Obstruction to the blood flow in heart in diseases like stenosis, embolism, thrombus, tumors, etc.

2. Drugs: Certain drugs like antihypertensives, ACE inhibitors, nitrates etc can cause syncope

3. Decreased body volume due to haemorrhage or other forms of fluid loss

4. Neurological conditions like seizures, stroke, etc, can cause syncope

5. Anxiety or stress-related disorders

Types of syncope based on the cause:

  • Vasovagal syncope: Most common type of syncope which occurs in response to extreme emotions like fear, anxiety, physical or mental stress. This kind of syncope is usually preceded by some impending signs of syncope like nausea, weakness, headache, blurred vision, etc. It resolves in few seconds to minutes
  • Orthostatic hypotension: Dizziness occurring due to sudden rising from sitting position or after prolonged standing is known as orthostatic hypotension. It can be caused due to diabetes, low body volume, anemia, etc.
  • Micturition syncope: Syncope occurring during or after the passage of urine
  • Other types can be deglutition syncope, defecation syncope, etc. These types are rare

What are the symptoms of fainting?

Syncope or fainting itself is a symptom in which the following occurs:

  • Fainting, falling
  • Lightheadedness, blackouts
  • Dizziness, unconsciousness
  • Convulsions may occur but it is rare
  • Nausea, vomiting
  • Blurring of vision before fainting
  • Palpitations, tingling sensations and numbness

What are the investigations that are carried out to diagnose a fainting episode?

  • Blood counts, blood pressure
  • Chest X-ray, echocardiography, ECG to look at heart abnormalities
  • CT scan, MRI to look for brain lesions
  • Drug history

What are the treatment for Fainting?

Syncope attacks can be dangerous and should be attended immediately. Treatment depends on the causes. Following are the commonly practiced treatment modalities:

  • Avoid making sudden changes in posture
  • Sufficient amount of water and salt should be taken to maintain body volume and avoid dehydration
  • Medications to improve blood circulation
  • If a patient has lost consciousness or is unable to breathe, CPR can be performed or ventilators can be used
  • Anticonvulsant medications can be given if convulsions are present
  • If syncope is stress or anxiety-related, practices like yoga and meditation can be helpful

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