Syncope: Symptoms, causes and treatment

Syncope, or fainting, is a temporary loss of consciousness with a quick recovery. Usually, it isn’t alarming, and most people don’t need follow-up treatment. However, treatment might be required for severe cases.

Fainting may or may not be associated with serious medical conditions. If it's caused by a temporary drop in blood flow, people usually recover without any medical intervention. Fainting for longer might cause injury to the brain and require medical attention, though.

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Syncope definition

Dizziness and lightheadedness are associated with fainting disorders. (Image via Unsplash/Nik Shuliahin)

Syncope (pronounced “sin-ko-pea”) is the medical term for fainting. It's associated with a sudden, temporary drop in the amount of blood that flows to the brain. The condition is usually temporary, and the person recovers rapidly. Fainting disorder is also another name for this condition.

Fainting is associated with:

• Sudden drop in blood pressure.
• Drop in the heart rate.
• Changes in blood flow.

People usually recover within minutes of experiencing fainting or dizziness. However, fainting disorders might be associated with other underlying medical conditions, like heart disease. Early diagnosis can prevent severe conditions and help with proper management.

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Types of syncope

There are different types of fainting, including:

• Vasovagal or neuro-cardiogenic: This is the most common type.
• Situational (also a type of vasovagal condition)
• Postural or orthostatic (also called postural hypotension)
• Cardiac
• Neurologic
• Postural orthostatic tachycardia syndrome (POTS)

The causes differ from one condition to another. Some of them are serious, while others are comparatively minor. Identifying the symptoms is crucial for proper diagnosis and treatment.

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Syncope symptoms & presyncope symptoms

The most common signs and symptoms include:

• Blacking out
• Lightheadedness
• Falling or fainting after physical activity
• Feeling dizzy
• Feeling drowsy or groggy
• Feeling unsteady while standing
• Tunnel vision
• Headaches

Some symptoms like nausea and headaches are associated with different disorders, so fainting must not be confused with them. If in doubt, it's best to consult a doctor for a proper diagnosis.

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Causes of fainting disorder

Heart disorders may cause fainting. (Image via Unsplash/Jesse Orrico)

Situational syncopes are triggered by situations and conditions, like:

• Dehydration
• Intense emotional stress
• Anxiety
• Fear
• Pain
• Hunger
• Use of alcohol or drugs
• Hyperventilation
• Coughing forcefully
• Urinating

Cardiac syncope can occur if there's a heart or blood vessel condition that affects blood flow to the brain. Such conditions are usually associated with

• Abnormal heart rhythm (arrhythmia)
• Obstructed blood flow (hypertrophic cardiomyopathy)
• Blockage in the heart’s blood vessels (myocardial ischemia)
• Valve Disease
• Aortic stenosis
• Blood clot
• Heart failure

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Diagnosis

There are several tests to determine the causes of syncope, including:

• Laboratory blood testing
• Electrocardiogram (EKG) to record the heart’s electrical activity
• Exercise stress test
• Ambulatory monitor to record heart rate and rhythm
• Echocardiogram
• Tilt table (head-up tilt test)
• Autonomic reflex testing

These tests must be taken under the supervision of a medical practitioner as per prescription.

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Treatment

Treatment and management depends on the severity of the condition. Some ways to manage fainting disorders are as follows:

• Taking medications under the supervision of a registered medical practitioner
• Wearing garments to improve blood circulation
• Eating small, frequent meals, increasing sodium and potassium intake and drinking more fluids
• Avoid caffeine and alcohol
• Elevating the head while sleeping, using pillows
• Management of heart disease
• Getting an implantable cardioverter defibrillator (ICD) for individuals with medical conditions

Commonly used medications for fainting disorders include:

• Midodrine
• Fludrocortisone

These medications must only be taken with proper advice and prescription of a doctor.

At a personal level, precautionary measures can have a huge impact on prevention of such conditions. People suffering from medical conditions must take extra care, especially during the summer, as dehydration is among the causes of fainting.

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Indranil Biswas is a nutritionist and personal trainer with a diploma in dietetics and personal training with a specialization in sports nutrition and strength training.

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