SYNCOPE: Types, Causes, Symptoms

all about syncope

The medical term for fainting is syncope. It refers to a short loss of consciousness that can follow by a complete and spontaneous recovery. Presyncope occurs when you feel dizzy or lightheadedness without losing consciousness. However, dizziness and lightheadedness are generic symptoms that can cause by diseases unrelated to syncope such as inner ear disorders.

Sudden cardiac arrest should not be confused with syncope. A person who suffers from sudden cardiac arrest loses consciousness quickly but will die if medical help is not given right away. Without treatment, a person who has syncope usually recovers rapidly. However, injury can occur during an episode, and recurrent episodes can be scary.

Furthermore, syncope may be a warning sign of more serious heart rhythms in persons with heart issues, necessitating a thorough examination. It’s critical to figure out what causes syncope so that it can avoid in the future. Identification of the cause of syncope may also reveal a serious underlying heart disease that needs to be resolved. However, low blood sugar, hyperventilation, mechanical falls, or seizures are some of the other causes of falling out. These are not syncope, but they should be evaluated and avoided.

Types Of Syncope

When there is an insufficient blood supply to the brain, syncope occurs. Syncope has no known cause. Approximately one-third of patients. Some drugs, however, increase the chance of syncope as a side effect. There are many possible causes, however, the following are the most common:

Vasovagal syncope

The most common type is vasovagal syncope. A sudden drop in blood pressure produces a reduction in blood supply to the brain, resulting in a stroke. Gravity causes blood to settle in the lower part of your body, below your diaphragm, when you stand up. When this happens, your heart and autonomic nervous system (ANS) work together to maintain constant blood pressure.

Orthostatic hypotension is a disorder that affects certain people with vasovagal syncope. This disorder prevents the patient’s blood vessels from shrinking (as they should) when they stand. Blood collects in the legs as a result, causing a rapid drop in blood pressure.

Postural syncope

A sudden drop in blood pressure produced by a sudden shift in position, such as from lying down to standing, is known as postural syncope. This syndrome can cause by certain drugs and dehydration. When people suffer from this type, their blood pressure drops by at least 20 mmHg systolic/top number and at least 10 mmHg diastolic/bottom number when they stand up.

A heart or blood vessel problem that impairs blood flow to the brain causes cardiac syncope. An irregular heart rhythm (arrhythmia), obstructed blood flow in the heart due to structural heart disease (the shape of the heart), blockage in the cardiac blood arteries (myocardial ischemia), valve disease, aortic stenosis, blood clot, or heart failure are examples of these disorders. It’s critical to see a cardiologist if you’re experiencing cardiac syncope.

Situational syncope

Vasovagal is a type of situational syncope. It only happens in certain conditions that disrupt the neurological system and cause syncope. Here are a few examples of these scenarios:

  • Fear
  • Pain
  • Anxiety
  • Dehydration
  • Hunger
  • Use of drugs
  • Coughing forcefully wearing a tight collar
  • Hyperventilation

Neurological syncope

A neurological condition such as a seizure, stroke, or transient ischemic attack can produce neurologic syncope (TIA). Migraines and normal pressure hydrocephalus are two less common causes of neurologic syncope.

Postural-Orthostatic Tachycardia Syndrome

Postural-Orthostatic Tachycardia Syndrome can cause by a rapid heart rate (tachycardia) that occurs when a person rises from a sitting or lying down position. The heart rate can increase by up to 30 beats per minute. Within 10 minutes of standing, the rise normally occurs. The condition affects mostly women, but it can also affect men.

Risk factors

Adults over the age of 80 are at a higher risk of hospitalization and mortality due to syncope. Younger people without a heart condition who have had syncope while standing or who have specific stress or situational triggers are less likely to have cardiac syncope.

Cardiac syncope is more common in adults over 60; men; people with a history of heart illness; short palpitations or sudden loss of consciousness; fainting when exercising; fainting while supine; an abnormal cardiac exam; or people with a family history of inheritable diseases. In older patients, other medical conditions and drugs are especially significant.


Syncope can cause by a variety of factors. Many people have a medical problem that affects the brain system or heart that they may or may not be aware of. You could also have a condition that prevents blood from flowing properly throughout your body, causing your blood pressure to drop when you shift positions, for example, going from lying down to standing.

causes of fainting


The common symptoms are:

  • Blacking out
  • Feeling dizzy
  • Fainting
  • Feeling drowsy
  • Headaches
  • Changes in vision
  • Feeling weak or unsteady when walking

Patients frequently sense the syncopal episode. Lightheadedness, nausea, and heart palpitations (irregular heartbeats that feel like “fluttering” in the chest) are examples of “premonitory symptoms.” If you suffer, you can probably avoid fainting if you sit or lie down and raise your legs if you have these symptoms. Syncope is a symptom of a more severe disease. As a result, it’s critical to get care as soon as possible after experiencing syncope. After receiving a correct diagnosis and appropriate treatment, the majority of patients may avoid difficulties.

How is syncope diagnosed?

If you experience this, consult your doctor, who can refer you to a syncope specialist for a thorough examination. A thorough review of your medical history and a physical examination are the first steps in the evaluation. Your doctor will inquire about your symptoms and episodes in detail, including whether you have any symptoms before fainting and when and where the episodes occur.

One or more tests may be performed to help your doctor in determining the cause of your syncope. These tests examine your heart’s condition, the pace at which it beats (heart rate), the amount of blood in your body (blood volume), and blood flow in different positions.

Tests to diagnose

The following tests can be used to determine the cause of syncope:

  • Blood tests are used to check for anemia and metabolic changes.
  • An electrocardiogram (EKG or ECG) is a test that records your heart’s electrical activity. To capture this information, electrodes (tiny adhesive patches) are attached to your skin.
  • A hemodynamic test is a technique that measures the blood flow and pressure inside your blood arteries as your heart muscle contracts and pumps blood throughout your body. Three sets of images are acquired after a small amount of a radioactive substance (tracer) is given through an intravenous (IV) line put in a vein in your arm.
  • Blood pressure, blood flow, heart rate, skin temperature, and sweating are all monitored during autonomic reflex testing in reaction to various stimuli. These measurements can help your doctor in determining whether your autonomic nervous system is functioning normally or whether nerve damage has happened.
  • Exercise stress test: An ECG can use to monitor the electrical activity of your heart while you are active. This can perform on a treadmill or stationary cycle to assist you to reach a specific heart rate.
  • In the Ambulatory monitor, You will wear a monitor that records information about your heart’s rate and rhythm using electrodes.
  • An echocardiogram is a test that creates an image of the heart structures using high-frequency sound waves.

The findings of the tests will help your doctor in determining what is causing your syncope. Electrophysiology examinations, autonomic nervous system testing, neurological evaluation, and computed tomography (CT) scan may require. Vestibular function testing can use to rule out inner ear issues. If you require more testing, your doctor will explain why you need it.

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