What is syncope?
El syncope, commonly known as Fainting o lipotimiaIs a transient loss of consciousnessIt is characterized by a sudden onset and spontaneous and complete recovery. It is marked by a momentary inability to stand and is often preceded by symptoms such as:
- Dizziness
- Cold sweats
- Blurred or tunnel vision
- Warmth sensation
- Pallor
- Nausea
- Ringing in the ears
In most cases, the person regains consciousness within seconds or minutes, without neurological aftereffects.
Vasovagal syncope: the most frequent cause
El vasovagal syncope It is the most common subtype of reflex or neurally mediated syncope, representing approximately 75% of cases.
What happens in the body?
The main cause is the overactivation of the vagus nerve in response to a triggering stimulus. This produces:
- Bradycardia (decreased heart rate)
- Peripheral vasodilation
- Lowering of blood pressure
- Transient decrease in cerebral blood flow
As a result, a momentary loss of consciousness occurs.
Most common triggering factors
Episodes can occur in different situations, such as:
- Intense emotional stress
- Sharp pain
- Standing for long periods of time
- Sudden changes in temperature
- Valsalva maneuvers (strenuous effort, defecation)
- See blood or during a blood draw
Although it usually occurs in healthy people with normal blood pressure, in some cases it can be associated with orthostatic hypotension (a drop in blood pressure when standing up).
Is fainting dangerous?
In the vast majority of cases, vasovagal syncope is benign and has an excellent prognosis.
- The recovery is quick and complete.
- It leaves no neurological aftereffects
- It does not require specialized treatment after an isolated episode.
Only a small percentage of patients consult with a specialist (approximately 3%) and less than 1% require hospitalization.
So when should we worry?
Medical evaluation is essential for rule out more serious cardiovascular causes, such as:
- Arrhythmias
- Structural heart disease
- Underlying heart disease
Especially if the syncope:
- It happens during exercise
- It appears without prior symptoms
- It is accompanied by chest pain or palpitations
- There is a family history of sudden death
What to do in case of fainting?
First aid
If you notice previous symptoms or witness an episode:
- Lie face up.
- Raise legs.
- Loosen tight clothing.
- Remain at rest until fully recovered.
These measures promote venous return and restore cerebral blood flow.
How to prevent new episodes
In cases of recurrent syncope, management focuses on the prevention.
Recognizing prodromal symptoms
If dizziness or sweating occurs:
- Cross your legs and tense them.
- Clench your fists.
- Contract the muscles of your arms and legs.
These isometric counterpressure maneuvers They can temporarily raise blood pressure and prevent fainting.
Changes in lifestyle
- Increase fluid intake.
- Moderately increase salt intake (if not contraindicated).
- Avoid known triggers.
- Engage in regular physical exercise.
- Use of elastic compression stockings in selected cases.
When should I see a cardiologist?
If the episodes are frequent or affect your quality of life, a complete cardiological evaluation, which may include:
- Electrocardiogram
- Holter monitoring
- Tilt table test
These tests allow us to confirm the diagnosis and rule out other causes.
Vasovagal syncope is, in most cases, a benign and transient phenomenon. However, a thorough medical evaluation is essential to rule out more serious cardiac conditions and reassure the patient.
If you have experienced a fainting episode or are experiencing recurring symptoms, in the Comprehensive Cardiology Unit We can help you identify the cause and establish the best personalized prevention and treatment plan.
At Dr. Lizandra Machín Martínez Cardiology specialist at UICAR