Syncope

Syncope comprises generalized weakness of muscles, loss of posture tone, inability to stand upright and a loss of consciousness.

The sequence of symptoms includes increasing lightheadedness, blurring of vision, proceeding blackout and loss of consciousness.

Mechanism 

Syncope is due to cerebral ischemia, more specifically to the brainstem. Cerebral ischemia may be due to vasodilatation or sudden fall in cardiac output, or both simultaneously.

Types of Syncope

Vasovagal Syncope

Cardiac Syncope

Orthostatic/Postural Syncope

Syncope associated with Cerebrovascular disease

Causes of Syncope

Carotid sinus syncope is common in elderly patients. It follows some form of compression of the carotid sinus, as in turning the head on one side, tight collar or shaving over the carotid sinus region.

Vagal and glossopharyngeal neuralgia.

Hypoglycemia.

Hypoventilation and hysterical fainting.

Cough syncope follows paroxysms of cough in the elderly with chronic bronchitis.

Treatment

Cardiac pacing, implantable defibrillators, and catheter ablation are the usual treatments of syncope caused by cardiac arrhythmias, depending on the mechanism of syncope.

A drug fludrocortisone acetate that's normally used to treat low blood pressure may help prevent vasovagal syncope. Selective serotonin reuptake inhibitors may be used. 

How to prevent syncope episodes?

Avoid triggers, such as standing for long time or the sight of blood.

Moderate exercise training.

Discontinuing medicines that lower blood pressure, like diuretics.

Eating a higher salt diet help keep up blood volume.

Drinking plenty of fluids to maintain blood volume.