What Is Syncope and What Happens When You Faint?

What Is Syncope?

Syncope is the medical term that is used for fainting or “passing out.” While syncope is very common, losing consciousness temporarily is very frightening and can be caused by a variety of reasons.

Generally, those who experience this temporary loss of consciousness will fall to the ground or slump over in the chair they are sitting in and then regain consciousness within a few seconds or minutes.

However, syncope can be a warning sign of a more serious condition. Unfortunately, it can be the first and only sign prior to sudden cardiac death. Therefore, it’s important to seek the expertise of a neurology specialist if you experience an episode of syncope.

In short, syncope is defined as having the following aspects:

1. Symptoms such as dizziness may be experienced before fainting.
2. A sudden loss of consciousness for a brief time.
3. Spontaneous recovery within a few seconds or minutes.

Causes of Syncope

Syncope occurs when there is a drop in blood pressure or a decrease in blood flow to your brain. There are several reasons why this could happen, and it will vary depending on the type of syncope. Syncope can also be caused by a medical condition that affects your nervous system or heart, including ventricular tachycardia.

Types of Syncope

Convulsive syncope is characterized by small jerking motions after passing out with spontaneous and complete recovery. This occurs because of a decreased blood flow to your brain, resulting in this seizure-like reaction.

Vasovagal syncope is the most common type of syncope. Vasovagal syncope is also known as neurally mediated syncope and occurs when your heart beats too slowly and/or blood vessels expand, resulting in less blood flowing to your brain.

It can also be the result of an emotional trigger. Common triggers of vasovagal syncope include emotional stress, prolonged standing, having blood drawn, severe pain, sneezing, coughing, etc.

Postural syncope (also known as orthostatic hypotension) is characterized by a sudden drop in systolic blood pressure and can occur when you change positions. Orthostatic hypotension can occur for the following reasons: volume depletion (dehydration, diarrhea, bleeding) and dysfunctional autonomic system (Parkinson’s disease, diabetes).

Additionally, medications taken for high blood pressure, depression, and psychiatric disorders can also cause this type of fainting. Those with postural orthostatic tachycardia syndrome may also experience fainting.

Cardiac syncope is the most concerning type of syncope because it originates from the heart when it isn’t operating the way that it should. Cardiac syncope can result from abnormal heart rhythms (abnormal heart rhythm, meaning too fast or slow) and mechanical obstruction (aortic stenosis, enlarged heart, or blood clot).

Situational syncope occurs only during specific situations that affect your nervous system and lead to passing out. Some of these situations include intense emotional stress, dehydration, fear, pain, anxiety, etc.

Carotid sinus syncope can occur when pressure is applied to your carotid artery, which is located in your neck.

How Is Syncope Diagnosed?

To make an accurate diagnosis of syncope, it is imperative for you to provide your specialist with a detailed record of the incident. Understandably, providing a detailed description may be difficult because you might not remember all the details due to fainting.

However, if possible, talk with those who witnessed the episode. The information they provide can prove to be very beneficial.

Your specialist may also ask you a series of questions, including the following:

• Do you have a history of fainting?
• What were you doing immediately before you fainted?
• Did you notice any symptoms right before you fainted?
• Did anyone witness what happened to you?
• How long did you lose consciousness?
• What medications are you currently taking?

Your neurologist will perform a physical examination and carefully review your medical history. Tests may be requested to help determine the reason behind your syncope, including:

• Electrocardiogram (ECG)
• Electroencephalogram (EEG)
• Electrolyte levels
• Tilt table test
• Blood pressure measurements in different positions
• Carotid sinus massage
• Carotid ultrasound

Syncope Treatment Options

Treatment options for syncope will depend on the specific cause of your syncope and the results of your evaluation and testing. The goal of treatment is to determine the cause of your fainting and avoid anything that may trigger it, if possible.

When you feel like you are about to faint, prevention techniques, such as laying down with feet elevated and using counter-pressure maneuvers, can help.

Visiting a neurologist after you have fainted or if you have recurrent syncope can be very helpful. Schedule an appointment with our board-certified neurologist, Dr. Martin Taylor, at OrthoNeuro today! We look forward to helping you feel at ease again.

Special thanks to Ellen Tan, OMS-lll for writing the original article entitled “SYNCOPE: WHAT REALLY HAPPENED WHEN YOU FAINTED.”