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Collapse, Fainting, Syncope – Definition, Causes, Symptoms and Treatment

Saturday, June 30th 2012. | Disease

Definition

Collapse, unconsciousness or syncope lasting only a few seconds and generate only rarely in death.

Fainting (syncope) is a disorder of consciousness of short duration which is caused by a temporary lack of blood and oxygen to the brain. If unconsciousness lasts longer than a minute, this is a medical emergency requiring a call from a doctor; loss of consciousness longer can be life-threatening or lifelong sequelae.

Causes

Heart

Syncope may occur due to heart disease like valvular heart disease, myocardial infarction or arrhythmia. The heart beats too fast, too slowly or too irregularly, in all these cases, the blood supply to the brain is temporarily restricted. Especially in the elderly, breaks called “black veil” occasionally occur.

Cardiac Circulation

Most often, this is a vasovagal syncope, that is to say, a sudden drop in blood pressure and pulse caused by an overreaction of the nervous system. This form of syncope most commonly affects healthy people and is often triggered by fear, pain or mental stress.

In addition, the sudden switch from a lying to standing position or prolonged standing may also cause loss of consciousness (syncope orthostatic). This type of syncope frequently affects people who are very thin or very large, which tend to have low blood pressure. In this case, the tension is no longer sufficient to supply blood to the brain in sufficient quantities. Diabetics are often affected by this form of syncope.

Brain

Narrowing of the vessels taking blood to the brain or cerebral vessels can also lead to decreased blood supply. Moreover, a modification of the carotid artery, usually in the form of calcification (arteriosclerosis), can trigger syncope when the subject turns his head sharply.

The following diseases may also cause syncope:

  • Inflammation of the brain and meninges.
  • Tumors and brain damage
  • Cerebral apoplexy
  • Seizures
fainting

Metabolism

A lack of nutrients in the blood, as in case of hypoglycemia, may be another cause of fainting.

Drugs and alcohol

Certain drugs can promote syncope (antihypertensive drugs, analgesics strong …). Withdrawal to alcohol or drugs is another factor likely to cause fainting.

Disorders (symptoms)

A tendency to sweating, nausea, dizziness, paleness and possibly palpitations often precede syncope. Often, individuals also describe the sudden appearance of a “black veil” before the eyes.

Particularly if abnormal heart rhythms, syncope may occur without any signs preliminary.

Examinations (diagnosis)

  • History taking into account the patient’s symptoms
  • Physical examination with pulse and blood pressure several times.
  • Laboratory tests to exclude metabolic disorders, inflammation and anemia.
  • Depending on the history and age: electrocardiogram (ECG), ECG recording over 24 hours, possibly, electroencephalogram (EEG) to record brain electrical activity, ultrasonic examination of the major arteries in the neck.

Treatment Options

Acute measures

First aid measures:

  • Allow the patient supine, lift her legs and cover with a warm blanket.
  • Do not leave the patient alone
  • After a few seconds, the patient should again react to speech

In cases of known diabetes and hypoglycemia, it may be worth giving a bit of sugar to the patient once again respond to speech.

If unconsciousness lasts longer than a few seconds :

First aid measures according to the diagram ABCD
A = Airway: clear the airways
B = Breathing: If not breathing, immediately perform two breaths into the nose
C = Compression: traffic, compression, cardiac massage
D = Defibrillation: Defibrillation, electroshock

Additional Measures

The further steps depend on the causes of unconsciousness. If an underlying condition is responsible, it must be treated.

Preventive Measures

If there is evidence harmless therapeutic measures are often limited to patient education, that is to say :

  • Avoid situations that trigger fainting.
  • Know the warning signs before fainting (eg signs of low blood sugar …)
  • Be sure to drink enough
  • Practice of cons-measures (cross or stretch your legs).

The situation is different for patients at risk and in particular, those for whom heart disease is the cause of syncope, those who are injured in a swoon (epilepsy) or those who belong to certain categories of professions as drivers or people working on machines …:

The decision to adopt the treatment to support syncope depends directly on accurate diagnosis, the patient’s general condition and its social environment and must therefore be taken, case by case, by the physician.

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