What is Syncope, What Are Its Types, When Should You See a Doctor?
Syncope, also known as fainting, is a condition that occurs as a result of a temporary decrease in blood flow to the brain.
Syncope, also known as fainting, is a condition that occurs as a result of a temporary decrease in blood flow to the brain. Syncope can occur due to different reasons. Since syncope may be a sign of a serious underlying condition, people who complain of fainting should apply to a well-equipped health center.
What is Syncope Known as Fainting?
The brain receives 15-20% of the blood pumped from the heart. If there is a decrease in the blood flow to the brain for various reasons, a condition called syncope occurs. Syncope, or fainting, is often accompanied by temporary loss of consciousness. After syncope, the person usually comes to his senses immediately and becomes conscious. It is normal for the person to feel a little confused and confused after syncope.
Syncope is a very common condition in society. Approximately 3.5% of women and 3% of men faint at some point in their lives. Syncope complaints become more common with age, and the rate of syncope in people over 75 years of age may increase up to 6%.
What are the Types of Syncope?
Syncope is a health problem that develops due to different reasons. Depending on what the underlying cause is, syncope can be divided into different subgroups:
Vasovagal Syncope (Cardio Neurogenic Syncope)
The most common type of fainting is vasovagal syncope. It occurs when a sudden drop in blood pressure causes a decrease in blood flow to the brain.
Due to human anatomy, when standing, blood collects in the lower part of the body due to gravity. The heart and autonomic nervous system try to compensate for this situation and keep blood pressure stable. When there is a problem in the compensation mechanism, blood pressure drops, blood flow to the brain decreases and syncope occurs.
Vasovagal syncope can occur triggered by both physical conditions and emotional factors. These triggering factors can be listed as follows:
- Dehydration (loss of fluid)
- intense emotional stress
- Alcohol or substance use
- Hyperventilation (rapid breathing)
- Severe cough, wearing tight-fitting sweaters (carotid sinus hypersensitivity)
- Urination (micturition syncope)
The following situations, which are common in society, also activate the vasovagal reflex and lead to syncope:
- seeing blood
- getting an injection, having blood drawn
- stand up quickly
- standing for a long time
- Facing an unexpected situation, such as having an accident
Postural Syncope (Positional Hypotension)
Postural syncope may occur as a result of changes in blood pressure due to position change. For example, standing up suddenly from a lying position can cause positional syncope. Dehydration and some medications can also trigger postural syncope. Postural syncope usually occurs when the systolic value (systolic blood pressure) drops by at least 20 mmHg and the diastolic value (diastolic blood pressure) drops by at least 10 mmHg with a change in position.
If the amount of blood flowing to the brain occurs due to a heart or vascular problem, fainting is called cardiac syncope. Cardiovascular diseases that can cause cardiac syncope can be listed as follows:
- Abnormal heart rhythm (arrhythmia)
- Impairment of blood flow due to a structural problem in the heart
- Blockage in the vessels feeding the heart (as in a heart attack)
- Heart valve disease, such as aortic valve stenosis
- blood clot
- Heart failure
People who have a known heart-related disease and experience fainting problems should definitely see a cardiologist. People who do not have a known disease but show symptoms of heart-related disease should also be examined in detail for cardiovascular disease.
Fainting due to a neurological disorder such as seizure, stroke, or transient ischemic attack is called neurological syncope. Conditions such as migraine and hydrocephalus may also be encountered as a cause of syncope, although rarely.
Postural Orthostatic Tachycardia Syndrome (POTS)
The condition in which the pulse is above normal as a result of standing up from a lying or sitting position is called postural orthostatic tachycardia syndrome. In this syndrome, the pulse can become 30 units or even faster than its normal course. POTS usually occurs within the first 10 minutes of standing up. The incidence of this syndrome is higher in women than in men.
What Causes Fainting?
Syncope; It may develop due to many cardiovascular, neurological and mental conditions. In order to understand the cause of syncope, the patient is asked what other complaints he/she has in addition to fainting, and the patient is examined in detail. Despite all these studies, the cause of approximately 1/3 of syncope cases cannot be fully elucidated.
What Does Fainting Affect the Body?
Other symptoms that may occur with fainting vary depending on the type of syncope. For example, in fainting due to arrhythmia, the patient may experience additional symptoms such as palpitations and sweating. In fainting due to stroke, symptoms such as change in the person’s mental state, speech impairment, and decrease in motor strength may occur.
Common symptoms associated with syncope can be listed as follows:
- Loss of consciousness
- falling down for no reason
- Feeling sluggish, tired
- Feeling faint after eating or exercising
- Feeling unsteady when standing or standing
- Vision disturbances, such as narrowing of the field of vision or seeing black spots
When to See a Doctor with Fainting Complaints?
People with a disease such as arrhythmia, epilepsy, orthostatic hypotension, which are known to be a symptom of syncope; He/she may experience fainting problems from time to time. If this situation is within the doctor’s knowledge and the person takes the necessary precautions against fainting, syncope may not be a very urgent situation. However, if sudden and unreasonable fainting develops, previously known fainting attacks become more frequent, or if there is no disorder that could explain the fainting, a doctor should be consulted as soon as possible.
How to Diagnose the Cause of Fainting?
Detailed medical histories of people who complain of fainting and consult a doctor are taken and examined. To investigate possible postural blood pressure changes, the patient’s blood pressure is measured by lying, sitting and standing. This test provides information about whether syncope is of positional origin.
To investigate possible causes of syncope, diagnostic methods such as 24-hour blood pressure monitoring, methods that show heart functions such as ECG or ECHO, and blood tests to see blood sugar or electrolyte levels can be used. Imaging methods such as brain tomography can also be used to detect neurological causes such as stroke and seizure.
What are the Treatment Methods for Fainting?
Treatment of fainting is aimed at the disorder that predisposes to syncope. It is not possible to completely correct syncope without correcting the underlying cause. Some of the methods used in the treatment of fainting are as follows:
- Changing medications currently being used
- Wearing socks and clothing that will help improve blood circulation
- Be careful when standing up
- Avoiding situations that trigger fainting
- Treating structural heart diseases with surgery or other methods
- Rhythm regulator battery insertion into the heart
- Consuming frequent and small portions, increasing the amount of salt consumed, drinking plenty of fluids and limiting the consumption of drinks containing caffeine.
Fainting treatment should be tailored according to the patient’s diseases, age and gender. Even if syncope occurs for the same reason, treatment that works for one patient may not be appropriate for another patient. It would be beneficial for people who experience fainting problems to apply to a well-equipped health institution for diagnosis and treatment. It should not be forgotten that fainting may be a symptom of a serious illness that can be life-threatening, and therefore people experiencing syncope should not hesitate to consult a doctor. We wish you healthy days.