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SYNCOPE

What Is Syncope?

  • Syncope is a term for fainting. It is a temporary loss of consciousness caused by a drop in blood pressure, which decreases blood flow to the brain.
  • Syncope can result from problems with blood pressure, structural heart problems, heart rhythm issues, or a dysfunction in the nervous system.
  • Syncope affects 3 out of every 10 people at some point in Life.

What Happens in Neurocardiogenic Syncope?

  • First, something triggers adrenaline to be released into the bloodstream.
  • The trigger might be an unpleasant sight, sudden severe pain, too much heat, dehydration, physical exercise, emotional distress, straining for a bowel movement, needles, or standing in one place for a long period (causing the blood to pool or collect in the legs).
  • The heart pumps more forcefully, and the nervous system may respond to this with an overactive or exaggerated response.
  • The heart rate slows, and the blood vessels in the legs dilate or widen. Blood pools in the legs, causing low blood pressure. This drop in blood pressure and slowed heart rate quickly results in less blood flow to the brain. This may lead to loss of consciousness or fainting.
  • Once a person falls or is lowered to the ground, the blood in the legs returns to the heart and brain, and the person wakes up quickly. However, the person may feel “washed out” or tired for a few minutes or even hours after an episode.

What Are the Signs and Symptoms?

Some people have no symptoms prior to fainting, and others may experience one or several of the following symptoms:

Pale appearance to your skin

Feeling of warmth

Palpitations or chest fluttering

Lightheadedness or dizziness

Nausea

Sweating

Rapid breathing

Altered vision

Trouble hearing or ringing in your ears

What Should You Do If You Have These Signs and Symptoms?

  • If you can feel the fainting spell coming on, sit or lie down quickly if at all possible.
  • Lying on your back with your knees bent may be helpful.
  • Do not stay standing or walk to get to a “private” place because you are likely to faint, fall to the ground, and potentially hurt yourself.
  • Do not sit with your head down toward your lap. This position does not help blood return from your legs to your head.
  • You may also try these additional techniques if you feel a fainting spell coming on. These activities help to constrict blood vessels quickly to raise both blood pressure and heart rate.

  1. Hold both arms across your chest and interlock your last four fingers. Try pulling your fingers apart with a strong counter-pressure maneuver and hold this movement until your symptoms start to resolve.
  2. If standing and unable to lie down quickly, cross your legs, then tense your legs, abdominal and buttock muscles (scissors position). Firmly squeeze your legs together and continue for 30 seconds after your symptoms pass.
  3. Drink a large glass of cold water.

Can Syncope Be Prevented?

Lifestyle changes may help some people prevent syncopal episodes. Understanding the problem and avoiding situations that seem to bring it on are all that is needed for some.

  • Drink more fluids. Water is the best fluid to drink but also use fruit juice or electrolyte drinks (like Gatorade) to replace fluid lost through sweating, exercise, heat, alcohol, or illness. Try to avoid fluids with caffeine that can dehydrate the body.
  • Avoid too much heat, too much alcohol, and standing in one place for long periods.
  • Be more cautious when you are ill, especially if vomiting or having diarrhea.
  • Increase salt intake. Salt helps you hold on to the fluids you drink. Try things like pretzels, pickles, canned soup, tomato juice, etc. (This may not be allowable if you have high blood pressure).
  • Avoid skipping meals.
  • Wear compression/support stockings. These stockings help keep some pressure on the legs and may help prevent blood pooling in the legs.

Medication

In most cases of neurocardiogenic syncope, treatment is aimed at preventing syncope with the lifestyle changes just mentioned.

Our doctors may prescribe medications that can help prevent further fainting episodes.

  • Beta-blockers: blocks the abnormal heart response that results in your symptoms
  • Midodrine: constricts or tightens blood vessels to decrease blood pooling in the legs
  • Florinef: helps your body retain extra fluid inside your blood vessels

Workup for Syncope

In addition to your provider obtaining a thorough history, the workup for syncope may include one or some of the following:

Treatment for Syncope

Treatment for syncope varies greatly and ultimately depends on the underlying cause. Treatment can be as simple as staying hydrated and making dietary modifications, or it may involve starting a medication. Treatment could also consist of undergoing a procedure if the cause of the syncope is determined to be heart rhythm related. Our qualified team of providers will work with you to determine the underlying cause of your syncope and then develop an appropriate treatment plan based on the underlying cause.

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