Syncope (Fainting)

Syncope (Fainting) Ankara

“Fainting”, which is also known as “syncope” in medical language, is a condition that can occur for many reasons. For this reason, syncope or fainting is not seen as a disease, it is accepted as a complaint that the patient tells us. To define it briefly, fainting is a temporary loss of consciousness and posture (posture) that develops suddenly. Sometimes patients do not completely faint, but they can come to the point of fainting. For this reason, they can say that it was “like fainting” or “a situation like fainting”. Such conditions are also called “presyncope” in medical language. The person who faints completely loses consciousness for a short time. If the person is standing, he/she can fall to the ground in an uncontrolled manner and cannot come to his senses for a while. Although fainting can occur due to simple psychological reasons, it can sometimes be a precursor of serious disorders. If fainting is not caused by external conditions or psychological reasons, it is generally considered as a condition related to brain and heart health. Arrhythmias and many anatomically based diseases of the heart can cause fainting. In the rest of our article, we will give detailed information about the causes of fainting. If you have more questions about syncope, you can contact clinic of Prof. Basri Amasyalı in Ankara.

What are the Reasons of Fainting?

Fainting occurs due to a serious decrease in blood flow to the brain and the severe low blood pressure that can accompany it. Due to the sudden decrease in blood flow to the brain, the consciousness of the person is lost and simultaneously with this event, we lose our upright position, which we call “posture”. As a result, the person collapses to the ground like a sack of potatoes. When the person regains consciousness after a while, he/she generally cannot remember what happened.

The sudden decrease in blood flow to the brain can develop due to many reasons. As I mentioned earlier, syncope is a symptom, not a disease. There are many reasons for this reason. The issue we want to focus on here is syncope related to the heart, and this generally accounts for about 20% of all syncopes. There is another syncope group that is outside of this 20% but still concerns the “Cardiology” department, which is called “vasovagal syncope” in medical language. I will address these later in this article.

In the examinations in approximately 20-30% of the patients with syncope, nothing can be found. Most of these patients have underlying psychological problems or other unknown causes. Adverse conditions that develop due to work life, private life or environmental unknown factors can cause syncope in such individuals. On the other hand, there is a fact that can be seen as positive regarding this patient group: Studies have shown that patients with syncope but for whom no cause was found in detailed examinations do not have an increased life risk compared to the normal population.

Now, I will try to briefly explain the important subgroups of syncope:

What is Cardiac Syncope (Heart Related Syncope)?

Cardiac syncope is also called cardiac soncope and is the most vital syncope group in the syncope subgroup. A significant majority of fainting occurs due to heart and heart-related diseases. Fainting due to heart rhythm disorder or diseases arising from the anatomical structure of the heart is called “cardiac syncope” in the medical language. Cardiac syncope can occur due to many heart-related diseases. However, the most common cause is cardiac arrhythmias. As a result of the change in the stroke volume of the heart, the blood flow in the brain can stop temporarily, and depending on the length of this cardiac arrest, the person can faint. Problems related to heart block along with arrhythmias, decreased heart rate, heart valve diseases, tumors in the heart, cardiac ischemia and heart attack can be counted among the causes of heart-related syncope.

Heart arrhythmias, i.e. rhythm disorders, can have many symptoms, from shortness of breath to fainting. Mild arrhythmia attacks usually only cause palpitations. Some patients do not even feel these mild attacks. However, moderate or severe arrhythmia attacks can cause fainting. Of course, factors such as the age of the person and whether there is any other concomitant disease in the heart are also important in the fainting of the person. While the same rhythm disorder can cause fainting in one person, it can only cause palpitation in another person. As soon as the heart rhythm improves, the person regains consciousness. These fainting can recur depending on the condition of the arrhythmia or can be one-off. For this reason, every patient who faints even once should consult a doctor.

What is Vasovagal Syncope?

Vasovagal syncope or “neurocardiogenic syncope” is one of the most common causes of fainting. Although it is classified in the syncope group not related to the heart, it is a syncope group that concerns the “cardiology” department. Basically, there is no problem in the heart in terms of anatomy or rhythm. The main problem is the sudden drop in blood pressure or pulse, which develops due to reflex mechanisms that do not function normally. Sometimes both happen at the same time. Let’s briefly explain this situation:

Normally, when a person stands up, a glass of blood pools in the foot vein system due to the effect of gravity, this can cause blood pressure to drop by causing blood loss in the body. But in healthy individuals, our body’s reflex mechanisms come into play and our blood pressure is prevented from falling. Reflex mechanisms already exist for such situations. The purpose of reflex mechanisms is to enable our body to react to changing conditions and to protect the body. As a result, when a person stands up from a lying or sitting position, by means of these reflex mechanisms; there is a slight contraction in all the veins of our body, especially the veins in the feet, and a slight increase in our pulse level. In this way, blood pressure drops are prevented. When there is a problem in the reflex mechanisms of the person, unfortunately, this order is disrupted and the person’s blood pressure or pulse suddenly drops and as a result, the person faints. This type of syncope happens when a nerve we call the “nervus vagus” takes an active role. For this reason, it is described as “neurally fainting” or “vasovagal syncope”. The factors such as anxiety, fear, suffocating environments, very hot environments, dehydration, pain shock, long standing and intense exercise can trigger this type of fainting.

What are Other Reasons of Syncope?

Except for cardiac and vasovagal syncope, the problems such as

  • Some lung diseases
  • Sara (epilepsy) disease
  • Some problems with brain vessels
  • Low blood sugar and
  • Problems with blood pressure can cause syncope.

Syncope (Fainting) Treatment

It is very important to bring the patient to himself/herself with appropriate intervention at the time of syncope. One wrong move can worsen the problem. For this reason, it is absolutely necessary to get help from experienced health officials to help the person who is unconscious. Once the blood pressure and pulse return to normal, the patient usually recovers. However, the causes of fainting must be determined. Since syncope can have many causes, it is very important to carry out detailed examinations and examinations during the diagnosis process.

The principle of treatment in syncope is to eliminate whatever the cause is. If there is a problem in the rhythm, it should be corrected, if there is a problem in the anatomy of the heart or in the valves, it should be operated if necessary, and if there is a correctable reason, it should be intervened; because, heart-related syncope is of vital importance and should be intervened without delay.

Vasovagal syncope, on the other hand, is a separate condition and it is essential in its treatment to control the provoking or triggering causes as much as possible. With some exercise programs, there are measures such as strengthening our foot muscles and conditioning the malfunctioning reflex mechanisms. In very persistent cases, drug treatment, which should be continued for many years, is also started.

For detailed information about cardiac syncope and other heart diseases, you can call our clinic in Ankara and make an appointment.

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