Syncope

Question: What can you tell me about syncope, especially the cardiac related? I'm doing a paper on heart conditions, and I have to talk about syncope caused by cardiac conditions. I've read some about it, but I'm trying to get the practical side of it. How ofter someone with the condition faints? For how long? What are the symptoms before it happens? Any ways to prevent those? What age range does it normally affect? Thanks.

Answer: Syncope can affect any age group. As you may have read, there are various reasons that may cause it. The frequency varies with individual. If the event is triggered, the person may have it once or twice in a lifetime, or weekly. The time in which they pass out also varies on what the initial cause of it is. Before someone faints, they may have less than a second up to a minute or so to know that it is going to happen. Often it is lightheartedness that they feel. They may feel dizzy, or suddenly weak. Prevention is focused on finding why it is happening. Good luck on your paper, and hope I helped!

Question: Does anyone else have vasovagal syncope? I have vasovagal syncope and i've never even heard of anyone else having it, but my doctor says its very common in people my age. Does anyone out there even know someone who has it?

Answer: i have it too. i have had it for about two years now. mine isnt too severe and i have it under control so it doesnt bother me too much anymore! i'm 17.

Question: How can I get over my vasovagal syncope in Health class? I am going to be a sophomore this year and I have health for the first semester. What triggers my nausea and fainting spells are usually when someone is describing a medical condition or something. Even last semester when my teacher was teaching CPR, I threw up and had to go home. Is there anyone else who has this? Are there any tips that would be good for helping me during this situation or to get my mind off of it at the time? Thank you soooo much!

Answer: I used to have this same thing! One cause was seeing blood, as in graphic abortion films and stuff that they made us watch back then. One was that I was underweight at that time and my blood pressure was very low; in VVS, it plummets even lower and you faint. Another was a too-warm room! So try not to get overheated, especially. Even as an adult, I was fainting when standing up out of a hot bath, because my blood pressure would drop so precipitously. Try putting a cold cloth or ice on your forehead, temples or the back of your neck. And you may just have to avoid gruesome sights and subjects altogether. Some people are just squeamish. I kind of grew out of it, literally, as I am overweight now and blood pressure is high. But I wouldn't recommend that avenue! Good luck.

Question: What is the difference between POTS and Neurocardiogenic syncope?

Answer: POTS also known as postural orthostatic tachycardia syndrome is caused by the bodies inability to react to a change in position. When you lay down for a while and then quickly change to a standing position, your body reacts by speeding up the heart (tachycardia) to compensate. Neurocardiogenic syncope is also known as vaso-vagal syndrome. In this instance the body responds to changes by dropping blood pressure and pulse rates. This can occur when you strain to hard at a bowel movement, after a really large meal, or any time you hold your breath and push really hard with your abdominal muscles.

Question: Is it safe to have elective surgery if you have vasovagal syncope? I have had fainting spells due to giving blood, emotional startles, etc...And in a month I am having elective surgery and I am wondering if it is safe for me to go under? And if not why? and if it is okay, how can I prepare?

Answer: it should not interfere in any way with the safety of the surgery, but be sure to tell the anesthesiologist, whom you will see prior to surgery, that you have this tendency.

Question: Is getting out of a tub a common cause of vasovagal syncope? I had just gotten home so i decided to take a very hot bath, so i was sitting. When i went to get out i began to come very dizzy, my vision faded to black and i could feel something in my ears,then i lost consciousness for what felt like a while. when i woke up from fainting i did not feel well. Is what happened to me vasovagal syncope, or a common cause of it?

Answer: I have had episodes of vasovagal syncope. However, I have never had an episode after sitting in hot water. I think it is normal for this to happen because hot water will expand your blood vessels which could result in less blood being pumped to your brain and therefore would result in dizziness and possible fainting. Once you have fainted, there is always a period of not feeling well which can last from a few minutes to a few hours. My vasovagal episodes are more related to drawing of blood or being involved in upsetting situations which trigger a drop in blood pressure and subsequent dizziness or fainting.

Question: what could the causes of syncope be without any medical reasons found? i have recurrent syncope and no one is able to find anything wrong with me. anyone have any ideas? I have had recurent syncope without any medical reasons, however, i do have this medical condition called postural orthostic tachycardia syndrom this could be a possible cause if it. still just other thoughts.

Answer: Postural orthostatic tachycardia could absolutely be the cause. Two issues to consider with this condition: First, it's completely possible that when you stand from a sitting position (or sit from a lying position...you get the idea), your blood pressure drops, causing a lack of blood (and therefore, oxygen) to your brain, resulting in your syncopal episodes. Second, when your blood pressure drops, baroreceptors in the carotid arteries and aorta signal the brain to increase the heart rate to build up pressure again. This is where you have episodes of tachycardia (or rapid heart rate). Sometimes in tachycardia, the heart can beat so quickly that the ventricles don't have time to refill before contracting again, which means that you aren't circulating adequate blood volume (in other terms, you aren't 'perfusing'). This, too can result in syncope.

Question: What is a "more extreme" condition than vasal vagal syncope ? When blood preasure is taken lying down, standing, and sitting. If the blood preasure difference is extreme enough, what is the other possible condition?

Answer: The underlying cause could be more severe. It could be epilepsy, heart problems, diabetes (high or low blood sugar), head injury, stroke, inner ear problems, or severe dehydration.

Question: Is syncope considered a medical emergency? Say the person collapses from a sudden drop in blood pressure, but comes to a few seconds later. Is that a medical emergency or is it something that can wait for a primary care doctor? Please answer, it's for a school report for my EMT class!!

Answer: I'm more with Phil than Matthew on this one, but I think the question is badly designed. If they are telling you that the syncope was due to a sudden drop in blood pressure, they are already telling you more than most people know when they present with a fainting spell. The problem with syncope is that the differential diagnosis is simply enormous, and the vast majority of possible diagnoses are relatively harmless, but it's those few dangerous ones that you have to watch out for. You don't *know* that it's due to blood pressure (something like orthostatic hypotension) without investigating. No one wakes up after fainting and says "Gee, that was weird how my blood pressure dropped for a few seconds there." Know what I mean? ;-) Uncomplicated syncope does not constitute a medical emergency. But there needs to be a lot more information before I could say whether I would want the patient to be seen immediately in the ER or wait for a regular appointment with their doctor--medical history, family history, history of present illness. I suspect this is more than they're going for with this question, and if the question is simply whether or not someone with a simple fainting spell and no other issues absolutely needs to be transported to the ER, my answer would be 'no'.

Question: Does neurocardiogenic syncope go away with time? I have known I have this condition since I was around 7 or 8. I'm 16 now and I've found that my parents aren't allowing me to do a lot of things because of it (ex. rockclimbing, scuba diving). We're going to visit a doctor about it to see what he suggests, but I'd kind of like to know a little of what to expect just so I don't get my hopes up. Thank you!

Answer: Neurocardiogenic syncope occurs when blood vessels tend to expand causing blood to pool in the lower extremities or legs of the patient. As a result, less blood reaches the brain and this causes the person to pass out. With neurocardiogenic syncope, when the blood pools in the legs, there is a miscommunication between the heart and the brain. Instead of the body releasing the hormone to make the heart rate beat harder and faster, a hormone is released causing the heart rate to slow down, which in turn causes the blood pressure to drop and makes the patient very dizzy and lightheaded to the point of passing out. Fainting is actually the body's recovery response in that it makes the person flat and removes the pooling effect of the blood which caused the passing out to begin with. To be diagnosed, you'd need to have a test called a H.U.T. or "head up tilt" test. This is done in a hospital usually, but basically they bring you in, start an I.V., you're placed on a table lying flat and then gradually the table is tilted upward to an almost standing position. Your heart rate and blood pressure is checked every few minutes to see how your body responds to position changes. The idea is to provoke an episode in a controlled setting. The cause of this condition still isn't very well understood, but it is suspected to be genetic in origin because it's common to find other family members with the same condition. It is also possible that its cause could be from severe dehydration, low salt intake, or prolonged lengths of time in an upright position in a warm environment. It is treated by some of the following: increasing fluid intake, increasing salt intake, medications (Florinef is one that our office uses), and changing activity patterns. This would include drinking less caffiene or alcholol, shifting weight when standing or sitting for prolonged periods of time, avoiding hot weather (staying inside on a very hot day). Hope this was somewhat helpful