Syncope: Treatment, symptoms, advice and help
Syncope is a sudden, temporary, loss of consciousness generally caused by insufficient oxygen supply to the brain as a consequence of decreased cerebral blood flow, usually secondary to systemic hypotension.
Syncope: Incidence, age and sex
Simple syncope is uncommon before age 10–12 year but is quite prevalent in adolescent girls.
Signs & symptoms of syncope: Diagnosis
Typical symptoms are dizziness, a diminishingion of vision, possibly tinnitus, complete loss of vision, weakness of limbs progressing to physical collapse. During a syncopal episode, an individual may have fixed upward deviation of the eyes that may sometimes be confused with epilepsy. Syncope can usually be differentiated from a seizure because of its short duration, associated symptoms of nausea and perspiration, and complete orientation after the event.
Causes and prevention of syncope
Simple syncope results from vasovagal stimulation and is precipitated by pain, fear, excitement, and extended periods of standing still, particularly in a warm environment. Factors that may increase the risk of fainting are fasting long hours, taking in too little food and fluids, low blood pressure, hypoglycemia, undue physical exercise , emotional distress, pregnancy and lack of sleep. More serious causes of fainting include cardiac arrhythmias, wherein the heart beats too slowly, too rapidly, or too irregularly to pump enough blood to the brain.
Whenever blood flow to the brain is reduced blood is diverted to the brain through vasoconstriction, which reduces blood flow in other body parts, and by increasing the pulse rate, tachycardia. These processes cause the typical symptoms of fainting: pale skin, rapid breathing, nausea and weakness of the limbs, particularly in the legs.
Prevention is by avoiding risk factors and when the individual feel like he or she is about to faint, to lie down and elevate the legs (this helps keep blood flowing to the brain). If lying down is not possible, to sit down and put the head between the knees. If this is recurrent , prevention can be with oral ß – adrenergic blocking agents.
The main complication is a prolonged loss of consciousness and injury due to a falls.
Recommended treatment involves returning blood to the brain by positioning the person on the ground, with legs slightly elevated or leaning forward and the head between the knees. After the symptoms have passed, sleep is recommended.