Syncope

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Introduction[edit | edit source]

Syncope, also known as fainting, is defined as the loss of consciousness for a short period of time followed by a rapid recovery. It is a common condition with a frequency ranging between 15% and 39%[1]. It becomes more common with aging where it affects 6% of individuals above the age of 75[2].

Clinical Signs and Symptoms[edit | edit source]

  1. Nausea and/or vomiting
  2. Lightheadedness
  3. Diaphoresis (sweaty palms)
  4. Visual disturbances (tunnel vision, blurred vision)[3]
  5. Headaches
  6. Palpitations
  7. Paraesthesia[4]

Differential Diagnosis[edit | edit source]

The underlying causes of syncope can be classified into four categories:

  • Reflex-mediated: It has three different variations which are vasovagal, carotid sinus and situational. This type of syncope has no increased risk of morbidity and mortality[5]. Vasovagal syncope occurs due to an inciting event or stimulus such as stress, pain, and prolonged standing. The stimulus is often identifiable and lying down or removing the stimulus usually aborts the syncopal episode[6]. Carotid sinus syncope is associated with syncope after head-turning, shaving and wearing a tight collar and can be relieved with a carotid sinus massage[7]. Situational syncope is associated with micturition, defecation, coughing and gastrointestinal stimulation[8].

[9]

References[edit | edit source]

  1. ↑ Da Silva RM. Syncope: epidemiology, etiology, and prognosis. Frontiers in physiology. 2014:471.
  2. ↑ Syncope: Symptoms, causes & treatments. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diseases/17536-syncope (accessed 9/1/2023)
  3. ↑ Syncope (fainting). RWJBarnabas Health. Available from: https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/syncope-fainting-/ (accessed 9/1/2023)
  4. ↑ White CM, Tsikouris JP. A review of pathophysiology and therapy of patients with vasovagal syncope. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2000 Feb;20(2):158-65.
  5. ↑ Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, Levy D. Incidence and prognosis of syncope. New England Journal of Medicine. 2002 Sep 19;347(12):878-85.
  6. ↑ Kaufmann H. Neurally mediated syncope: pathogenesis, diagnosis, and treatment. Neurology. 1995 Apr 1;45(5):12-8.
  7. ↑ Puggioni E, Guiducci V, Brignole M, Menozzi C, Oddone D, Donateo P, Croci F, Solano A, Lolli G, Tomasi C, Bottoni N. Results and complications of the carotid sinus massage performed according to the “method of symptoms”. American Journal of Cardiology. 2002 Mar 1;89(5):599-601.
  8. ↑ Arthur W, Kaye GC. The pathophysiology of common causes of syncope. Postgraduate medical journal. 2000 Dec 1;76(902):750-3.
  9. ↑ trainaesthesia.Carotid Sinus Massage(2017). Available from: http://www.youtube.com/watch?v=EsMk2wX2Guw[last accessed 12/1/2023]
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