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What is syncope? Causes, Symptoms and Treatment

Syncope is a transient, short-lived loss of consciousness that ceases spontaneously. It is due to a sudden and transient fall of the blood circulation of the brain.
This transitory defect of oxygen supply to the brain is enough to cause a loss of consciousness and a collapse of the muscle tone, causing a fall of the person.

Syncope accounts for 1.21% of emergency room admissions and their cause is then known in 75% of cases.

Diagnosis of syncope

to determine that there has been syncope, the doctor is based on an interrogation of the person who has had syncope and his entourage, which provides valuable information on the causes of syncope.

A clinical examination is also carried out by the doctor, as well as possibly an electrocardiogram, or even other examinations (electro-encephalogram) always to try to understand the reason for this syncope.
The purpose of the interrogation, the clinical examination and the complementary examinations is to differentiate a true syncope from other types of loss of consciousness related to intoxication by a drug, a toxic substance, or psychoactive (alcohol, drug), to a epileptic seizure, stroke, alcohol intoxication, hypoglycaemia, etc.

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Cause of syncope

  • Syncope can have several causes:
    A reflex origin and it is then essentially a vasovagal syncope. This reflex syncope occurs as a result of stimulation of the vagal nerve, for example because of pain or a strong emotion, stress or fatigue. This stimulation significantly slows the heart rate which can lead to syncope. These are benign syncope, ceasing on their own.
  • Hypotension, which concerns mostly the elderly. These are orthostatic syncopations (when changing position, especially from lying to standing or squatting to standing) or postprandial syncope (after a meal).
  • Cardiac origin, related to heart rhythm disease or cardiac muscle disease.

Vasovagal syncope is by far the most common. It can affect young people, as early as adolescence and we then often find a triggering factor (intense pain, emotion, anxiety crisis). This triggering factor is often the same for the same person and frequently proceeded by warning signs, which generally avoids a traumatic fall.

This vasovagal syncope also affects the elderly but, in this case, the triggering factors are much more rarely found and the fall is often much more brutal (which can lead to the risk of bone trauma).

True syncope is to be distinguished from other forms of unconsciousness, for example, those related to epileptic seizures, stroke, alcohol intoxication, hypoglycemia, etc.

What are the symptoms of syncope?

  • The syncope may be preceded by warning signs with a feeling of discomfort, cutaneous pallor, sweating, or even nausea.
  • It can also occur without warning sign resulting in a sudden fall with, in this case, a risk of increased trauma.
  • Both forms of syncope can exist during the life of the same person.
  • The syncope itself is a loss of consciousness, with or without a fall depending on whether the person perceives discomfort or not and whether or not he has time to lie down.

People at risk for syncope

Syncope affects about 3% of the population.
People at risk are:
– Those who have already had syncope with 30% of recurrences in the same person and 30% of traumatic falls.
– Seniors, especially those taking multiple medications, have a higher risk.

– People with arterial hypertension.
– People with diabetes (hypertension and diabetes undermine the self-regulation systems of cerebral blood flow.

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Prevention of syncope

Prevention depends of course on the type of syncope and especially its causes. It is obviously not always possible, the syncope often occurring by surprise. Nevertheless some precautions of common sense can prevent certain syncope:
– To avoid the excess of drugs in the old people.
– Avoid taking unnecessary psychoactive drugs.
– Avoid the use of drugs (excess alcohol included)

– Do not change position abruptly in case of orthostatic syncope.

Medical treatment of syncope:

There is no cure for typical vasovagal syncope, since it resolves itself. Risk situations should be avoided only when a specific triggering factor exists. We need to evaluate the existence of favoring factors, particularly among seniors who often take several medications, which may be the cause.
For people with heart disease or heart muscle, it is essential that they are fully followed by a cardiologist.

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