What is syncope and what types are there?

Syncope is a very common situation. It consists of the temporary loss of consciousness and postural tone. That is, it is a temporary loss of consciousness. It is caused by a decrease in blood flow to the brain.

Many people use the term Fainting instead of syncope. The fact that there may be a decrease in cerebral blood flow can be due to multiple reasons. That is why different types are distinguished based on their etiology.

General symptoms of syncope

Syncope, as we have seen in the introduction, is defined as the transitory loss of consciousness and postural tone. As explained by a study published in Frontiers in Physiology it is a very frequent problem. So much so, that its incidence is estimated between 15 and 39% of the general population.

What's more, can affect people of any age and gender. However, it is true that as you age, its incidence increases. From 70 years of age this problem becomes more common.

Fainting is usually accompanied by a series of very characteristic symptoms. As stated in the MSD Manual, presyncope is characterized by the perception of dizziness and imminent fainting. However, there is no real loss of consciousness yet.

A person who suffers a syncope does lose it. The skin is usually cold and clammy. The pulse weakens and the breathing becomes very shallow. Just before losing consciousness, there is usually lightheadedness, blurred vision, headache, and weakness.

In some cases involuntary muscle movements may appear. They may look like seizures, although they are not. This is one of the most relevant differential diagnoses to perform.

What types of syncope are there?

We have previously pointed out that syncope is caused by a decrease in blood flow to the brain. This, in turn, can have multiple causes. So Different types are distinguished that we will explain in the following sections.

Syncope has different types of presentation. Before the event itself, a presyncope may occur.

Neuromediated syncope

This type is also known as reflex syncope. It is the most frequent. What happens is that certain reflexes of the autonomic nervous system are deregulated, which is responsible for maintaining blood pressure and heart rate.

Because of this, the heart slows down and blood pressure drops. This means less blood flow to the brain.

The vasovagal variant, as explained by specialists from the Mayo Clinic, is one that occurs when the body reacts disproportionately to certain triggers. For example, in the face of pain or strong emotions.

On the other hand, we found the fainting related to the carotid sinus. It appears when putting pressure on the carotid artery, which sits on the neck. It is common in some men while shaving or when wearing very tight ties.

Finally, neuro-mediated syncope can also be situational, when performing specific actions or movements. The most common is that it appears when you cough or laugh.

Fainting of cardiac origin

Cardiac or cardiogenic syncope, as the name suggests, is due to a problem with the heart. The most common cause is arrhythmias, such as tachycardias.

There may also be a structural problem, such as valve disorders or ischemic cardiomyopathy. These people often experience palpitations and chest pain.

Orthostatic syncope

Orthostatic syncope is one that occurs when a person stands up. As explained by a study published in Offarm, the cause is that this movement causes a sharp drop in blood pressure.

Sometimes it is related to certain drugs consumed. For example, with antidepressants. It can also be associated with alcohol consumption, dehydration, and blood loss.

Cerebrovascular syncope

Cerebrovascular syncope is associated with a problem with the blood vessels responsible for delivering oxygenated blood to the brain. It is one of the least frequent and is more serious.

For example, it may be due to the presence of aneurysms or be behind a stroke. In most cases, the cause stems from an atherosclerosis problem that reduces the caliber of the arteries and prevents blood from flowing normally.

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How to deal with the different types of syncope

Earlier we saw that syncope was characterized by a series of symptoms and that some of them act as a warning of what is going to happen. It is important to know how to act to prevent possible complications related to falls or blows when losing consciousness.

Faced with a syncope of your own

When the feeling of weakness or imminent fainting appears It is essential to find a place to sit or lie down.Ideally, lie down with your legs raised to help the blood flow down with the pull of gravity into the brain.

Thus, in addition, the risk of falling if fainting finally appears. When the postural tone is lost and falls, it is possible to hit the head against any object or the ground itself.

It is important to lie down or sit until the feeling of dizziness subsides. In the same way, when the time comes to get up you have to do it slowly and progressive.

Help others

If we see someone dizzy or fainting, try to help them. The first thing is to check if it has been hit and if it breathes. It is important to remember that lung dynamics are usually weaker and more superficial, but it should be felt.

In any case, it is also essential to ask for help. Especially if that person does not regain consciousness or has an injury.

Helping someone with syncope requires speed and having emergency contact on hand.

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How can the differential diagnosis be made?

The fact that there are so many reasons why fainting can occur makes a differential diagnosis difficult at times. Although it is true that the vast majority of cases are benign and transitory, when it is repeated it is essential to find the reason.

That is why the doctor must know the complete medical history of the patient. Especially if you suffer from any type of illness or if you take any drug. In addition, it is important to carry out a correct examination.

The most commonly used complementary tests are the electrocardiogram and the echocardiogram. The first allows us to observe what the electrical activity of the heart is like. It is a simple, innocuous and low cost test. The electrocardiogram, for its part, provides a detailed image of cardiac morphology.

A stress test may also be prescribed. Carotid sinus massage consists of massaging the carotid to see if, when doing so, syncope occurs. It is complemented with magnetic resonance imaging or computed tomography.

Some syncope can be prevented

Syncope often occurs with certain triggers that can be easily identified. For example, they usually appear when there is low blood sugar or dehydration.

Therefore, an easy way to avoid fainting is to eat several times a day, even in smaller amounts. Similarly, you have to drink enough water. Avoiding alcohol and other drugs, such as marijuana, also reduce your risk.

Every time you have to get up, it is recommended to do it slowly and progressively. Even more so if you have been lying down for a long time. Nevertheless, if fainting occurs frequently, consult a doctor.

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