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Syncope

Syncope  is a synonym for fainting or passing out. Someone is considered to have syncope if they become unconscious and go limp, then soon recover. Anywhere from 1/3 to 1/2 of all people will experience at least one syncopal episode during their lifetime. Additionally, 1%-3% of all emergency department visits are related to syncope. Even if the cause of an episode is benign, syncope can result in injury from falls, motor vehicle accidents, and other mechanisms.

According to the Cardiology guidelines, the diagnosis and management of syncope, primary autonomic failure falls under the category of syncope due to orthostatic hypotension, specifically neurogenic orthostatic hypotension. Examples of syncope-inducing conditions include Lewy body dementia, Parkinson’s disease, and multiple system atrophy.

Syncope has a range of etiologies and can be a symptom of serious conditions.

Causation:

The cause of fainting can be as simple (and temporary) as anxiety that causes hyperventilation (breathing too fast) or heat illness from working hard in the sun. But fainting can also be a symptom of a sudden and lethal heart condition.

Serious heart conditions that can cause syncope include:

If the heart beats too fast or too slow, it can't keep the blood pressure up as high as it needs to be.Blood drains from the brain and leads to fainting. During a heart attack, the heart muscle can become too weak to maintain blood pressure.

Dehydration: Too little water in the bloodstream lowers blood pressure, and stimulating the vagus nerve when the system is already low can lead to dizziness and fainting.

There are many causes of dehydration, including vomiting or diarrhea. Vomiting and diarrhea, specifically, are related to vagus nerve function.

Shock is a condition characterized by low blood pressure that often leads to a loss of consciousness and very low Blood Pressure.

Shock is a life-threatening emergency that usually comes from bleeding but can also result from severe allergy.  Severe infection can lead to shock. People with shock will most likely become confused, and then lose consciousness as their condition gets worse.

Alcohol misuse and Drug abuse can cause people to pass out. Besides its obvious sedation effect, alcohol makes people urinate, which will eventually lead to dehydration. It also dilates blood vessels, which decreases blood pressure.

Like shock, losing consciousness due to alcohol is not technically considered fainting, but it may be a cause for concern.

Some medications can increase the risk of passing out, whether taken alone or when interacting with other drugs and supplements. They include:10

Orthostatic Hypotension(a drop in blood pressure when you stand up) can cause you to pass out suddenly. It has several potential causes, including Parkinson's disease. But medications are one of the most common reasons for episodes of this type of fainting. It differs from postural orthostatic tachycardia syndrome (POTS), which often causes younger people to pass out when standing up.

SYNCOPE is a serious medical condition that must be addressed right away. Seek Help promptly and without delay. Alternatively, call 911.

Author
Paddy Kalish OD, JD and B.Arch

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