Chủ Nhật, 12 tháng 1, 2014

Syncope

Syncope Syncope is the medical term used for loss of consciousness or blacking out. The person who faints suddenly will get back to wakefulness shortly. Decreased supply of the blood to the brain can cause syncope. Fainting occurs when the blood supply or oxygen is cut off to the reticular activating system in the brain. Brain contains reticular activating system which is responsible for keeping a person awake.


Similarly for staying awake and alert one of the two hemispheres of the brain should be functioning. Sometimes the right and left hemispheres are deprived off blood supply causing syncope. For some people blood supply will be turned off to the entire brain for few seconds making them to lose consciousness. The person who loses conscious will soon regain it most of the time. But he may be confused for some time until he regains full consciousness. Syncope often occurs due to medical issues with the heart or blood flow.


Symptoms :


Some of the signs that accompany syncope or fainting are given below:-


• Sudden falling without any reason


• Blacking out


• Fainting or feeling drowsy


• Light headedness


• Fainting occurs often after exercising or having a meal


• Feeling dizzy


• Unable to stand properly


• Difficulty in concentrating


• Nausea/vomiting and increased palpitations


Some of the above symptoms are preceded by actual fainting out phenomenon. Some people will feel discomfort and lightheaded and nauseated before fainting. Some people will suddenly feel very weak as though the entire room spins around them. It can cause blurring of vision and tingling sensation or numbness in the arms and legs.


Often, the person will get to know the symptoms that they are going to “pass out” and they either sit down and relax or inform others for getting medical help. There may be some confusion for the person who faints for few minutes which will resolve on its own. Once the person gets relieved from the episode of syncope he/she will have symptoms that have caused fainting.


Causes :


The main reason for syncope is decreased blood flow to the brain. There are several factors that can affect the quality blood flow that enters your brain. It can occur if the heart cannot pump enough blood to the brain. Sometimes the blood vessels will not have enough tone/capacity to pump the required volumes of blood to the brain. The blood vessels may not contain enough blood fluids in it. Syncope can occur due to two or more factors mentioned below.


Changes in Heart Rhythm :


Sudden changes in heart rhythm will make subsequent changes in blood pressure causing disruption of blood supply to the brain. Tachycardia is an abnormal heart rhythm can be potentially dangerous. Similarly bradycardia is slow heartbeat which can cause insufficient blood flow to the brain.


Structural Abnormality of the Heart :


Any type of damage or structural abnormality in the heart can cause syncope. With the damaged valve the heart may not be able to pump blood efficiently to the brain. Certain abnormal heart valve diseases and narrowing of blood vessel can stop or disrupt blood supply to the brain.


Heart Muscle Thickening :


This is common among athletes and people who do strenuous exercises. The heart muscle will become thick and enlarged obstructing the blood flow that leaves the heart causing syncope. Postural hypotension can cause syncope and this is more particular if the person suddenly stands up from sitting or lying posture. Fainting can also occur due to vasovagal syncope. Sudden chemical imbalance in the body can trigger blood pressure to shoot up causing dilation of blood vessel letting only insufficient volumes of blood to the brain.


Anemia :


Syncope can occur due to anemia or low RBC count since there may not be sufficient oxygenated blood flow to the brain.


Dehydration :


If the body gets dehydrated due to vomiting or diarrhea it can disrupt the normal blood supply causing syncope. Similarly any changes in the electrolyte level and sudden hormonal changes can also cause syncope.


Types of Syncope :


Cardio Neurogenic Syncope :


It is also called vasovagal syncope where the blood pressure decreases suddenly. The normal blood flow will be disturbed when you stand up from prolonged sitting posture causing increased blood flow to the lower body parts leading to drop in blood pressure.


Situational Syncope :


Anxiety attack is an example of situational syncope causing sudden stimulation of nerves causing dehydration and emotional stress.


Neurologic Syncope :


It is caused by imbalance in neurological condition like stroke, seizure and transient ischemic attack.


Cardiac Syncope :


Loss of consciousness can occur due to abnormal heart functions and valve diseases making one to faint.


Tests and Diagnoses :


The doctor will collect the medical history of the patient from his friends and relatives to identify what exactly has caused syncope. He will conduct routine physical examination looking for heart rhythm disturbance and he will monitor blood pressure in different positions. Electrocardiogram, blood test, and imaging tests like CT scan or MRI will be done to rule out any anomalies in the blood vessels of the heart.


Treatment :


Syncope is not serious or life threatening provided the affected person wakes up with full alertness. Emergency treatment is to be given if the person is not able to breathe properly. CPR is to be done to restore normal breathing or he/she must be put on artificial ventilator. The treatment for syncope depends on the results of diagnoses and actual cause of syncope. Blood circulation will be improved by giving medications and also by wearing compression stockings.


Taking a healthy diet that contains sufficient quantities of sodium and potassium is recommended. One should not make sudden changes in posture and allow the space required for the body to adjust to changed position. Keep your head in elevated position while sleeping to facilitate increased blood flow to the brain. Practice yoga or meditation and any other relaxation techniques to manage stressful situations.


Prevention :


People who are old should take precautions while changing position giving enough time for the body’s reflex mechanism. In case medications given for blood pressure are causing syncope alternative medicines are given. If you are above 50 years then you can make regular screening tests to avoid sudden complications in the heart.


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