We are standing, it is very hot, we have just done an intense exercise… suddenly we feel weak, dizzy, we start to see only red or blue spots until we finally fall to the ground, losing consciousness for a few seconds. This is an example of what would happen if we were suffering from syncope or fainting .

Defining syncope

Syncope or fainting is defined as a transient episode of loss of consciousness , which occurs suddenly and unexpectedly due to a decrease in brain flow to the brain and which can have many causes.

This is a frequent symptom in all types of population that does not necessarily reflect a disorder, although on some occasions it may indicate or be given by the presence of coronary pathologies or metabolic disorders.

Usually a series of symptoms can be found first that warn the body that something is not working well before losing consciousness, so we can find that syncopes usually act over two moments.

The loss of consciousness is usually short, may be almost imperceptible and last a few seconds or a few minutes. However, in extreme conditions where the causes of loss of consciousness are serious pathologies, this loss of consciousness may reflect the entry into a coma or even culminate in the death of the patient .

Its two phases

As we have seen, although the loss of consciousness may be sudden, in a large number of cases the person suffering from syncope does not simply lose consciousness, but presents a series of symptoms prior to his or her collapse that warn the individual that something is happening. This is why we can talk about syncope itself and presyncope.

Presyncope

Presyncope is defined as the set of symptoms that occur prior to the subject losing consciousness. In these previous moments the subject experiences a deep sensation of dizziness , gastrointestinal discomfort, alterations in thermal perception and the sensation of muscular weakness.

One of the most common symptoms is tunnel vision which becomes increasingly blurred while perceiving points of light (whose colour may vary from person to person). It is common to have a headache and break out in a profusion of sweat.

Depending on the case, complete loss of consciousness may not occur if the person is able to rest, calm down, or resolve the reason for the situation.

Syncope

Syncope itself occurs when the subject loses consciousness, that is, when he or she faints. In this situation there is a total or almost total muscular hypotonia that causes the subject to fall to the ground if he is not holding on or leaning somewhere, together with a temporary loss of consciousness. The pupils dilate and the pulse slows down.

Types of syncope

As we have said, the causes of syncope can be multiple and variable. Specifically, we can find three main groups depending on whether we are dealing with syncope produced by cardiac disorders or other types of causes, the latter being the most frequent group.

Cardiogenic syncopes

Syncopes of cardiac origin are usually the most dangerous and potentially fatal type of syncope, because the loss of consciousness is caused by an alteration of the body at a cardiovascular level.

This type of syncopes can come from the blockage or acceleration of the atria or ventricles or the different veins and arteries. Thus, can occur in cases of arrhythmia such as tachycardias and bradycardias, and structural heart disease

Syncopes due to orthostatic hypotension

This type of syncopes are episodes of loss of consciousness that can also be potentially dangerous . In this case there is a reduction in orthostatic pressure or the ability to regulate blood pressure.

It usually occurs with episodes of hypoglycemia (malnutrition or diabetes are usually causes of this type of syncopes), dehydration, blood loss due to bleeding or consumption of certain drugs or substances. Its causes must be treated very quickly or the subject’s life may be endangered.

Reflex or neuromediated syncope

This is the most common and known type of syncopation, present in most of the population without any known pathology.

They highlight the vasovagal syncope, which comes from the stimulation of the vagus nerve usually due to situations such as high temperature, standing or making too fast movements, physical pain, anxiety or the experience of emotions or extreme situations. Situational syncope is also common and is linked to a specific situation.

Treatment

Syncope or fainting is usually a transitory alteration in which the sufferer ends up recovering without any kind of sequelae. However, it is necessary to establish what the causes have been, especially in patients with previous heart problems. In fact, a sudden syncope due to cardiac causes could be a symptom of heart failure and end up with the death of the patient.

In cases not resulting from heart problems, the treatment to be applied may change depending on the specific cause . Many of them are produced by low blood pressure that do not pose any danger and have spontaneous recovery, such as those produced by vasovagal reactions.

However, sometimes they can occur as a result of dangerous conditions such as hypoglycemia in people with diabetes . In this case it is essential to quickly consume sugar or some food or drink that contains it before the loss of consciousness occurs, as well as hydration and rest for a few moments, checking the blood sugar level.

Remedies

In case of loss of consciousness it may be necessary to administer glucagon (not insulin, which is usually the injection carried by those affected by this metabolic disorder, since it would have a contrary and harmful effect) by the medical services or an acquaintance or relative who knows the amount to be administered.

In the cases that are due to high anxiety, it is recommended to avoid the stressful situation temporarily, although if it is recurrent, it could be advisable to do tasks that allow the progressive habituation and adaptation to the anxious situation . Tranquilizers and beta-blockers can also be used if necessary. If it occurs in the elderly and in the face of changes in position, the use of compression stockings is recommended, which can help regulate blood flow.

In the case of heart conditions, the rapid intervention of medical services is required , who will carry out the most appropriate treatment according to the specific cause. This can range from the administration of anticoagulants, a defibrillator, surgery or the implantation of a pacemaker.

Bibliographic references:

  • Moya, A.; Rivas, N.; Sarrias, A.; Pérez, J. & Rova, I. (2012). Syncope. Rev. Esp. Cariol. vol.65, 8.
  • Hairstyle, R. (2014). Presyncope: A symptom with the same prognostic significance as syncope? Rev. Cardiac Sp. Vol.57 (7); 613-6.
  • Gutiérrez, O. (1996). Syncope: Diagnosis and treatment. Peru Cardiol; XXII (1): 30-38.