Understanding syncope: causes, symptoms, and when to seek help

Syncope, commonly known as fainting, is a temporary loss of consciousness caused by a sudden drop in blood flow to the brain. Typically, the episode is brief, lasting only a few seconds to minutes, with the person usually regaining consciousness without lasting effects.

Syncope is relatively common, with nearly one in three people experiencing it at least once in their lifetime. Although it’s often harmless, syncope can sometimes signal an underlying medical condition, so understanding its causes, symptoms, and when to seek medical attention is important.

Types of syncope

There are several types of syncope, each associated with different triggers. Vasovagal syncope, the most common type, occurs due to a reflex response that causes blood vessels to dilate and the heart rate to slow, leading to a drop in blood pressure and reduced blood flow to the brain. This type is often triggered by stress, dehydration, prolonged standing, or seeing blood.

Another type, situational syncope, happens in specific situations, such as coughing, swallowing, or even urinating, and is often related to physical triggers that temporarily affect blood flow. Cardiac syncope is caused by heart-related issues, such as arrhythmias or structural problems in the heart, which disrupt normal blood circulation. Finally, orthostatic hypotension occurs when a person stands up quickly, causing a temporary drop in blood pressure.

Symptoms

The main symptoms of syncope are a sudden loss of consciousness, but often there are warning signs such as lightheadedness, dizziness, nausea, sweating, blurred vision, or a feeling of warmth. These symptoms may allow the individual to recognise an episode is coming and take measures to prevent it, such as sitting down or lying flat.

While many cases of syncope are benign, it's essential to seek medical attention if fainting occurs frequently or without a clear trigger, as this can signal an underlying heart or neurological condition. Diagnosis often involves a physical exam, blood pressure measurements, an ECG, or further tests like a tilt-table test to analyse blood pressure and heart rate.

Treatment

Treatment for syncope depends on its underlying cause. For instance, lifestyle changes such as increasing fluid intake, avoiding long periods of standing, or managing stress can help prevent vasovagal syncope. In cases where syncope is linked to a heart condition, medical treatment or even surgery may be necessary. By identifying and addressing the root causes, people can manage syncope and reduce its impact on daily life.