![]() A recent genetic study has identified first risk locus for syncope and collapse. There also seems to be a genetic component to syncope. ![]() Issues with the heart and blood vessels are the cause in about 10% and typically the most serious while neurally mediated is the most common. There are three broad categories of causes: heart or blood vessel related reflex, also known as neurally mediated and orthostatic hypotension. Ĭauses range from non-serious to potentially fatal. The risk of a poor outcome, however, depends very much on the underlying cause. Of those presenting with syncope to an emergency department, about 4% died in the next 30 days. Up to half of women over the age of 80 and a third of medical students describe at least one event at some point in their lives. It is the reason for one to three percent of visits to emergency departments and admissions to hospital. It is more common in older people and females. ![]() Syncope affects about three to six out of every thousand people each year. Those who are considered at high risk following investigation may be admitted to hospital for further monitoring of the heart. Treatment depends on the underlying cause. Other causes of similar symptoms that should be considered include seizure, stroke, concussion, low blood oxygen, low blood sugar, drug intoxication and some psychiatric disorders among others. Computed tomography (CT) is generally not required unless specific concerns are present. More specific tests such as implantable loop recorders, tilt table testing or carotid sinus massage may be useful in uncertain cases. Low blood pressure and a fast heart rate after the event may indicate blood loss or dehydration, while low blood oxygen levels may be seen following the event in those with pulmonary embolism. Heart related causes also often have little history of a prodrome. The ECG is useful to detect an abnormal heart rhythm, poor blood flow to the heart muscle and other electrical issues, such as long QT syndrome and Brugada syndrome. Ī medical history, physical examination, and electrocardiogram (ECG) are the most effective ways to determine the underlying cause. This is often due to medications that a person is taking but may also be related to dehydration, significant bleeding or infection. The third type of syncope is due to a drop in blood pressure when changing position such as when standing up. Neurally mediated syncope may also occur when an area in the neck known as the carotid sinus is pressed. This may occur from either a triggering event such as exposure to blood, pain, strong feelings or a specific activity such as urination, vomiting, or coughing. Neurally mediated syncope occurs when blood vessels expand and heart rate decreases inappropriately. Heart related causes may include an abnormal heart rhythm, problems with the heart valves or heart muscle and blockages of blood vessels from a pulmonary embolism or aortic dissection among others. It is recommended that presyncope be treated the same as syncope. When consciousness and muscle strength are not completely lost, it is called presyncope. Psychiatric causes can also be determined when a patient experiences fear, anxiety, or panic particularly before a stressful event, usually medical in nature. Syncope may also be associated with a short episode of muscle twitching. There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea, vomiting, or feeling warm. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. Syncope, commonly known as fainting, or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. Medical history, physical examination, electrocardiogram Loss of consciousness and muscle strength Ĭardiac, reflex, orthostatic hypotension ![]()
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