What is SYNCOPE?
Syncope is the medical term for fainting and precisely defined as a transient loss of consciousness followed by the return to full wakefulness. Syncope often includes dizziness and temporary loss of vision commonly referred as “blackout”, nausea and abdominal discomfort.
What is the cause of SYNCOPE?
Causes of syncope may be Non Cardiac or Cardiac
Non-Cardiac – Dehydration causing vaso- vagal syncope or reflex syncope
• Hypoglycaemia
• Brain Stroke
Cardiac – Abnormal Heart Rhythm
• Structural Heart disease (Heart Valve)
• Congenital Heart Disease
What are the types of SYNCOPE?
Neurocardiogenic or reflex syncope underlie most forms of syncope. It is by far the most common cause of transient loss of consciousness. The three main types of reflex syncope are neurocardiogenic syncope, carotid sinus syncope and situational syncope. Neurocardiogenic syncope is provoked by triggering events such as prolonged stranding, emotion, pain, sight of blood. Carotid sinus syncope is caused by stimulation of the carotid sinus baroreceptors in the neck, which leads to low blood pressure or slow heart rate of both. Situational syncope is defined as loss of consciousness at the onset of, during or directly after swallowing, defection, micturition or coughing.
How Common is Reflex SYNCOPE in a Population?
Most of us have experienced an episode of pre-syncope or syncope in our life-time. Neurocardiogenic Syncope is labeled as a benign syncope. However it has its nuisance value for unpredictability of occurrence. Recurrent episodes of fainting spells however require further treatment as they are associated with fall and injuries which at times may be severe or fatal. Neurocardiogenic syncope is much more common in older patients due to autonomic disorders. However in the age group of 12-18 years it is very commonly seen due to bat eating habits, stress and not enough intake of fluids.
How SYNCOPE can be diagnosed?
As which most medical conditions, the history is the key in finding our way a patient faints. Initial diagnostic tests may include an
1. Electrocardiogram (ECG)
2. Screening blood tests like a complete blood count (CBC), electrolytes, glucose, kidney function tests and Thyroid blood tests.
3. Holter Monitoring can be done to determine transient disturbances in heart rate Holter monitoring can be done which patient needs to wear for 24 or 48 hours or for up to 30 days.
4. Tilt-table test (HUTT) can be used to uncover neurocardiogenic syncope and is usually done on an outpatient basis.
What happen if SYNCOPE is not treated?
Syncope is a sudden event and can be life threatening is not treated properly. Fainting can cause injury if it occurs while participating in an activity like driving a car.
What are the treatment options available for SYNCOPE?
Following are the available precautions and treatment:
• Life Style Modification
-Avoidance of triggers known to cause syncope.
-Drink plenty of fluids
-Increase salt intake
-Avoid temperature extremes
-Avoid long periods of standing, and never stand up quickly or “jump up” quickly from a reclining position.
-Be vigilant for the onset of warning sings
Although syncope appears a “Benign” modality, it can be disabling and has a profound effect on quality of life however with accurate diagnosis and appropriate treatment, it can be resolved. Always talk to your Cardiac Electrophysiologist for right treatment for you by Dr Vanita Arora.
Dr Vanita Arora is a Senior Consultant Cardiac Electrophysiologist & Interventional Cardiologist with Max Super Speciality Hospital, Saket.
• Drug and Device Therapy
-Drugs- If syncope is caused by abnormal heart rate drugs can be given to treat that.
-Surgary-If there is a mechanical obstruction to blood flow, that obstruction must be removed surgically.
-Device Therapy- If syncope is related to arrhythmias there are two options. If it’s caused by slow heart rate then Permanent Pacemaker Implantation is required to treat this problem.
If syncope is due to abnormal high heart rate or a family history of unexplained sudden cardiac death, these patients show be implanted with an ICD which detects arrhythmias and uses electrical shocks to restore normal heart rhythm.
Syncope is the medical term for fainting and precisely defined as a transient loss of consciousness followed by the return to full wakefulness. Syncope often includes dizziness and temporary loss of vision commonly referred as “blackout”, nausea and abdominal discomfort.
What is the cause of SYNCOPE?
Causes of syncope may be Non Cardiac or Cardiac
Non-Cardiac – Dehydration causing vaso- vagal syncope or reflex syncope
• Hypoglycaemia
• Brain Stroke
Cardiac – Abnormal Heart Rhythm
• Structural Heart disease (Heart Valve)
• Congenital Heart Disease
What are the types of SYNCOPE?
Neurocardiogenic or reflex syncope underlie most forms of syncope. It is by far the most common cause of transient loss of consciousness. The three main types of reflex syncope are neurocardiogenic syncope, carotid sinus syncope and situational syncope. Neurocardiogenic syncope is provoked by triggering events such as prolonged stranding, emotion, pain, sight of blood. Carotid sinus syncope is caused by stimulation of the carotid sinus baroreceptors in the neck, which leads to low blood pressure or slow heart rate of both. Situational syncope is defined as loss of consciousness at the onset of, during or directly after swallowing, defection, micturition or coughing.
How Common is Reflex SYNCOPE in a Population?
Most of us have experienced an episode of pre-syncope or syncope in our life-time. Neurocardiogenic Syncope is labeled as a benign syncope. However it has its nuisance value for unpredictability of occurrence. Recurrent episodes of fainting spells however require further treatment as they are associated with fall and injuries which at times may be severe or fatal. Neurocardiogenic syncope is much more common in older patients due to autonomic disorders. However in the age group of 12-18 years it is very commonly seen due to bat eating habits, stress and not enough intake of fluids.
How SYNCOPE can be diagnosed?
As which most medical conditions, the history is the key in finding our way a patient faints. Initial diagnostic tests may include an
1. Electrocardiogram (ECG)
2. Screening blood tests like a complete blood count (CBC), electrolytes, glucose, kidney function tests and Thyroid blood tests.
3. Holter Monitoring can be done to determine transient disturbances in heart rate Holter monitoring can be done which patient needs to wear for 24 or 48 hours or for up to 30 days.
4. Tilt-table test (HUTT) can be used to uncover neurocardiogenic syncope and is usually done on an outpatient basis.
What happen if SYNCOPE is not treated?
Syncope is a sudden event and can be life threatening is not treated properly. Fainting can cause injury if it occurs while participating in an activity like driving a car.
What are the treatment options available for SYNCOPE?
Following are the available precautions and treatment:
• Life Style Modification
-Avoidance of triggers known to cause syncope.
-Drink plenty of fluids
-Increase salt intake
-Avoid temperature extremes
-Avoid long periods of standing, and never stand up quickly or “jump up” quickly from a reclining position.
-Be vigilant for the onset of warning sings
Although syncope appears a “Benign” modality, it can be disabling and has a profound effect on quality of life however with accurate diagnosis and appropriate treatment, it can be resolved. Always talk to your Cardiac Electrophysiologist for right treatment for you by Dr Vanita Arora.
Dr Vanita Arora is a Senior Consultant Cardiac Electrophysiologist & Interventional Cardiologist with Max Super Speciality Hospital, Saket.
• Drug and Device Therapy
-Drugs- If syncope is caused by abnormal heart rate drugs can be given to treat that.
-Surgary-If there is a mechanical obstruction to blood flow, that obstruction must be removed surgically.
-Device Therapy- If syncope is related to arrhythmias there are two options. If it’s caused by slow heart rate then Permanent Pacemaker Implantation is required to treat this problem.
If syncope is due to abnormal high heart rate or a family history of unexplained sudden cardiac death, these patients show be implanted with an ICD which detects arrhythmias and uses electrical shocks to restore normal heart rhythm.
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