Cardiovascular syncope is better known as fainting, usually caused by inadequate blood flow to the brain.
Symptoms
Syncope is a sudden, often dramatic but temporary, loss of consciousness when the brain doesn’t get enough oxygen. It’s possible to make a subtle distinction between syncope and fainting, with the former often resulting in hospitalization and the latter typically not requiring such care.
Someone who faints, in fact, might even remember falling.
Some signs before the fall:
- Shortness of breath.
- Dizziness.
- Excessive yawning.
- Weakness.
- Blurred vision.
- Heart palpitations.
- Pale, sweaty skin.
- Chest discomfort.
- Tunnel vision.
Causes
Syncope is most often attributed to low blood pressure.
Other possible causes:
- Dehydration
- Overheating
- Exhaustion
- Pain
- Stress
- Pooling of blood in the legs after sudden position change.
Vasovagal syncope: An overstimulated vagus nerve, the longest cranial nerve, is a common cause of fainting. It’s your body’s extreme reaction to a trigger, whether emotional duress or an unpleasant sight.
As you age, your risk of syncope increases. These conditions also increase your risk:
- Chest pain.
- Coronary artery disease.
- Previous heart attack.
- Cardiomyopathy (a disease of the heart muscle).
- Ventricular dysfunction (when the muscle stiffens, the ventricle cannot relax normally)
- A syncope might indicate a serious disorder when:
- Accompanied by palpitations or heart irregularities.
- During exercise.
- A family history includes sudden death or multiple syncope.
Fainting also might be the only sign of Long QT Syndrome, or LQTS, an inherited electrical disorder of the heart. The sudden, uncontrollable arrhythmias – often caused by exercise or stress – are considered a common cause of sudden, unexplained death in children and young adults.
If someone near you faints:
- Position the person on his or her back, face up. This improves oxygen flow and levels the heart rate.
- If you detect breathing, raise the person’s legs by the heels 8-10 inches above their heart level. This helps resume blood flow to the brain.
- Check for improved blood and oxygen circulation. If the skin remains pale and cool, blood flow remains problematic.
- At that point, perform CPR or, if you’re not familiar with CPR, request assistance from someone nearby.
- Make sure someone has called 9-1-1.
Treatment
If heart pain precedes syncope, your doctor might recommend one or more of these tests:
EKG: An electrocardiogram, records the spikes and dips of your heart’s electrical activity, typically with a device connected to a laptop that stores the results.
Holter monitor: A device worn by the patient that records the heart’s electrical signals for a much longer period, usually 24 or 48 hours.
Blood tests: These could reveal diabetes, anemia or an infection.
Tilt-table test: Blood pressure, heart rate and heart rhythm monitored while the patient shifts from lying down to standing up. In this scenario, blood pressure and heart rate change to ensure the brain gets enough blood. If they don’t change, this could explain why the patient fainted.
Carotid sinus: Gently massaging the carotid artery (on the side of your neck) for several seconds while monitoring your heart rhythm and blood pressure. The carotid sinus, swelling in the main arteries that supply blood to the brain, monitors and adjusts blood pressure if it’s too low or too high. Your doctor will watch for any lightheadedness or dizziness.
Procedures
Cardiovascular syncope can be controlled, even stopped, with one or more of these procedures:
Pacemaker: A small device inserted beneath the skin in the chest or abdomen area. A pacemaker evaluates a heart’s rhythm, then sends an electrical pulse to the heart when it senses an abnormality to restore a normal rhythm.
Catheter ablation: When medication fails, this procedure can stop abnormal electrical rhythms or signals from affecting the heart by scarring tissue causing the problem. Electrodes placed in your heart measure the electrical activity, then target the tissue.
Implantable cardioverter defibrillator: An implanted device designed to prevent potentially deadly arrhythmias using pulses or shocks to restore normal rhythms.
Maze: Using small incisions, radio waves or other methods, a surgeon creates scar tissue that, because it does not conduct electrical activity, blocks arrhythmia-causing electrical signals.
Cardioversion: Electric shocks delivered to the heart through electrodes placed on your chest restores the heart’s normal rhythms. Doctors often prefer this procedure for abnormal rhythms originating in the atria, the heart’s upper chambers.
Implantable cardioverter defibrillator: An implanted device designed to prevent potentially deadly arrhythmias using pulses or shocks to restore normal rhythms.
Maze: Using small incisions, radio waves or other methods, a surgeon creates scar tissue that, because it does not conduct electrical activity, blocks arrhythmia-causing electrical signals.
Catheter ablation: Tiny areas of tissue causing abnormal electrical signals are destroyed by a surge of energy delivered through flexible thin tubes – the catheters – inserted into a vein, usually in the groin or neck.
Getting a pacemaker: