What makes them faint? Why people faint - causes of sudden loss of consciousness

Temporary loss of consciousness caused by transient general hypoperfusion of the brain. The clinical picture of syncope consists of precursors (lack of air, “lightheadedness,” fog or “floaters” before the eyes, dizziness), a period of lack of consciousness and a recovery stage in which weakness, hypotension, and dizziness persist. Diagnosis of syncope is based on tilt test data, clinical and biochemical tests, ECG, EEG, USDG of extracranial vessels. For patients with fainting, differentiated therapy is usually used, aimed at eliminating the etiopathogenetic mechanisms of the development of paroxysms. In the absence of convincing data on the genesis of syncope, undifferentiated treatment is carried out.

General information

Fainting (syncope, syncope) was previously regarded as a transient loss of consciousness with loss of postural tone. Indeed, it is a disorder of muscle tone that leads to a person falling when fainting. However, many other conditions fit this definition: various types of epileptic seizures, hypoglycemia, head injury, TIA, acute alcohol intoxication, etc. Therefore, in 2009, another definition was adopted, interpreting fainting as a transient loss of consciousness caused by general cerebral hypoperfusion.

According to generalized data, up to 50% of people have fainted at least once during their lives. Typically, the first episode of syncope occurs between 10 and 30 years of age, with a peak at puberty. Population-based studies indicate that the incidence of syncope increases with age. In 35% of patients, repeated fainting occurs within three years after the first.

Global transient cerebral ischemia, causing fainting, can have a variety of causes, both neurogenic and somatic nature. The variety of etiopathogenetic mechanisms of syncope and its episodic nature explains the significant difficulties that doctors face in diagnosing the causes and choosing therapeutic tactics when fainting. The above emphasizes the interdisciplinary relevance of this problem, requiring the participation of specialists in the field of neurology, cardiology, and traumatology.

Causes of fainting

Normal blood flow cerebral arteries estimated at 60-100 ml of blood per 100 g of brain matter per minute. Its sharp decrease to 20 ml per 100 g per minute causes fainting. Factors that cause a sudden decrease in the volume of blood entering the cerebral vessels can be: a decrease in cardiac output (with myocardial infarction, massive acute blood loss, severe arrhythmia, ventricular tachycardia, bradycardia, hypovolemia due to profuse diarrhea), narrowing of the lumen of the arteries supplying the brain (with atherosclerosis, occlusion of the carotid arteries, vascular spasm), dilatation of blood vessels, rapid change body position (so-called orthostatic collapse).

Changes in tone (dilatation or spasm) of the vessels supplying the brain are often neuroreflex in nature and are the leading cause of syncope. Such fainting can provoke a strong psycho-emotional experience, pain, irritation of the carotid sinus (during coughing, swallowing, sneezing) and the vagus nerve (during otoscopy, gastrocardial syndrome), an attack of acute cholecystitis or renal colic, trigeminal neuralgia, glossopharyngeal neuralgia, an attack of vegetative-vascular dystonia, overdose of certain pharmaceuticals, etc.

Another mechanism that provokes fainting is a decrease in blood oxygenation, i.e., a decrease in the oxygen content in the blood with normal blood volume. Syncope of this origin can be observed with blood diseases (iron deficiency anemia, sickle cell anemia), carbon monoxide poisoning, respiratory diseases (bronchial asthma, obstructive bronchitis). Fainting can also be caused by a decrease in CO2 in the blood, which is often observed with hyperventilation. According to some data, about 41% are due to fainting, the etiology of which cannot be determined.

Classification of fainting

Attempts to systematize the various types of fainting have led to the creation of several classifications. Most of them are based on the etiopathogenetic principle. The group of neurogenic syncope includes vasovagal conditions, which are based on sharp vasodilation, and irritative ones (carotid sinus syndrome, syncope with glossopharyngeal and trigeminal neuralgia). Orthostatic syncope includes fainting caused by autonomic failure, decreased blood volume, and drug-induced orthostatic hypotension. Cardiogenic type syncope occurs due to cardiovascular diseases: hypertrophic cardiomyopathy, stenosis pulmonary artery, aortic stenosis, pulmonary hypertension, atrial myxoma, myocardial infarction, valvular heart defects. Arrhythmogenic syncope is provoked by the presence of arrhythmia (AV block, tachycardia, SSSU), malfunction of the pacemaker, side effect antiarrhythmics. There is also cerebrovascular (dyscirculatory) syncope associated with pathology of the vessels supplying blood to cerebral structures. Fainting, the trigger factor of which could not be determined, is classified as atypical.

Clinical picture of fainting

The maximum duration of syncope does not exceed 30 minutes; in most cases, fainting lasts no more than 2-3 minutes. Despite this, during the course of fainting, 3 stages are clearly visible: the presyncope state (precursor period), the fainting itself, and the postsyncope state (recovery period). The clinical picture and duration of each stage are highly variable and depend on the pathogenetic mechanisms underlying fainting.

The presyncope period lasts several seconds or minutes. It is described by patients as a feeling of lightheadedness, severe weakness, dizziness, lack of air, blurred vision. Possible nausea, flashing dots before the eyes, ringing in the ears. If a person manages to sit down with his head down or lie down, then loss of consciousness may not occur. Otherwise, the increase in these manifestations ends in loss of consciousness and fall. With the slow development of fainting, the patient, falling, holds on to surrounding objects, which allows him to avoid injury. A rapidly developing syncope can lead to serious consequences: head injury, fracture, spinal injury, etc.

During the period of fainting itself, a loss of consciousness varying in depth is noted, accompanied by shallow breathing and complete muscle relaxation. When examining a patient during the period of fainting, mydriasis and a slow reaction of the pupils to light, weak filling of the pulse, and arterial hypotension are observed. Tendon reflexes are intact. A deep disturbance of consciousness during fainting with severe cerebral hypoxia can occur with the occurrence of short-term convulsions and involuntary urination. But such a single syncopal paroxysm is not a reason to diagnose epilepsy.

The post-syncope period of syncope usually lasts no more than a few minutes, but can last 1-2 hours. There is some weakness and uncertainty of movements, dizziness, low blood pressure and pallor persist. Possible dry mouth, hyperhidrosis. It is typical that patients remember well everything that happened before the moment of loss of consciousness. This feature makes it possible to exclude TBI, which is typically characterized by the presence of retrograde amnesia. The absence of neurological deficit and general cerebral symptoms makes it possible to differentiate syncope from stroke.

Clinic of selected types of fainting

Vasovagal syncope- the most common type of syncope. Its pathogenetic mechanism consists of sharp peripheral vasodilation. The trigger for an attack can be prolonged standing, staying in a stuffy place, overheating (in a bathhouse, on the beach), excessive emotional reaction, pain impulse, etc. Vasovagal syncope develops only in an upright state. If the patient manages to lie down or sit down, or leave a stuffy or hot room, then fainting may end in the presyncope stage. The vasovagal type of syncope is characterized by pronounced stages. The first stage lasts up to 3 minutes, during which patients manage to tell others that they “feel bad.” The stage of fainting itself lasts 1-2 minutes and is accompanied by hyperhidrosis, pallor, muscle hypotension, a drop in blood pressure with a thread-like pulse at a normal heart rate. In the post-syncope stage (from 5 minutes to 1 hour), weakness comes to the fore.

Cerebrovascular syncope often occurs with spinal pathology in cervical spine(spondyloarthrosis, osteochondrosis, spondylosis). The pathognomonic trigger for this type of syncope is sudden turning of the head. The resulting compression of the vertebral artery leads to sudden cerebral ischemia, leading to loss of consciousness. At the presyncopal stage, photopsia, tinnitus, and sometimes intense cephalgia are possible. Fainting itself is characterized by a sharp weakening of postural tone, which persists in the postsyncopal stage.

Irritative fainting develops as a consequence of reflex bradycardia when the vagus nerve is irritated by impulses from its receptor zones. The appearance of such fainting can be observed with achalasia cardia, peptic ulcer of the 12th colon, hyperkinesia of the biliary tract and other diseases accompanied by the formation of abnormal viscero-visceral reflexes. Each type of irritative syncope has its own trigger, for example, a specific attack of pain, swallowing, gastroscopy. This type of syncope is characterized by a short, just a few seconds, period of warning signs. Consciousness turns off for 1-2 minutes. There is often no post-syncope period. As a rule, repeated stereotypic fainting is observed.

Cardio- and arrhythmogenic syncope observed in 13% of patients with myocardial infarction. In such cases, syncope is the first symptom and seriously complicates the diagnosis of the underlying pathology. Features are: occurrence regardless of the person’s position, the presence of symptoms of cardiogenic collapse, great depth of loss of consciousness, repetition of syncopal paroxysm when the patient tries to get up after the first fainting. Syncope, included in the clinical picture of Morgagni–Edams–Stokes syndrome, is characterized by the absence of precursors, the inability to determine the pulse and heartbeat, pallor, reaching the point of cyanosis, and the beginning of the recovery of consciousness after the appearance of heart contractions.

Orthostatic syncope develops only during the transition from a horizontal position to a vertical position. It is observed in hypotensive patients, persons with autonomic dysfunction, elderly and debilitated patients. Typically, such patients indicate repeated cases of dizziness or “fogging” with a sudden change in body position. Often, orthostatic syncope is not pathological condition and does not require additional treatment.

Diagnostics

A thorough and consistent interview of the patient, aimed at identifying the trigger that provoked fainting and analysis of the clinical features of syncope, allows the doctor to establish the type of fainting, adequately determine the need and direction of a diagnostic search for the pathology behind syncope. In this case, the first priority is to exclude urgent conditions that can manifest as fainting (PE, acute myocardial ischemia, bleeding, etc.). At the second stage, it is determined whether syncope is a manifestation of an organic disease of the brain (aneurysm of cerebral vessels, etc.). The initial examination of the patient is carried out by a therapist or pediatrician, neurologist. In the future, you may need to consult a cardiologist, epileptologist, MSCT or MRI of the brain, MRA, duplex scanning or transcranial ultrasound, radiography of the spine in the cervical region.

In the diagnosis of syncope of unknown origin, the tilt test has found widespread use, making it possible to determine the mechanism of occurrence of syncope.

First aid for fainting

The primary goal is to create conditions that promote better oxygenation of the brain. To do this, place the patient in a horizontal position, loosen the tie, unbutton the collar of the shirt, and provide fresh air. Splashing in the patient's face cold water and bringing ammonia to the nose, they try to cause reflex excitation of the vascular and respiratory centers. In case of severe syncope with a significant drop in blood pressure, if the above actions are not successful, the administration of sympathicotonic drugs (ephedrine, phenylephrine) is indicated. For arrhythmia, antiarrhythmics are recommended; for cardiac arrest, administration of atropine and chest compressions.

Treatment of patients with syncope

Therapeutic tactics in patients with syncope are divided into undifferentiated and differentiated treatment. An undifferentiated approach is common to all types of syncope and is especially relevant when the genesis of syncope is unknown. Its main directions are: reducing the threshold of neurovascular excitability, increasing the level of autonomic stability, achieving a state of mental balance. First-line drugs in the treatment of fainting are b-blockers (atenolol, metoprolol). If there are contraindications to the use of beta-blockers, ephedrine and theophylline are used. Second-line drugs include vagolytics (disopyramide, scopolamine). It is possible to prescribe vasoconstrictors (etafedrine, midodrine), serotonin uptake inhibitors (methylphenidate, sertraline). In combination treatment, various sedatives(valerian root extract, lemon mint and peppermint extract, ergotamine, ergotoxin, belladonna extract, phenobarbital), sometimes tranquilizers (oxazepam, medazepam, phenazepam).

Differentiated therapy for fainting is selected according to its type and clinical characteristics. Thus, the treatment of fainting in carotid sinus syndrome is based on the use of sympatho- and anticholinergic drugs. IN severe cases surgical denervation of the sinus is indicated. The main treatment for syncope associated with trigeminal or glossopharyngeal neuralgia is the use of anticonvulsants (carbamazepine). Vasovagal syncope is treated primarily as part of undifferentiated therapy.

Recurrent orthostatic syncope requires measures aimed at limiting the volume of blood deposited in the lower body when moving to an upright position. To achieve peripheral vasoconstriction, dihydroergotamine and α-adrenergic agonists are prescribed to block vasodilation peripheral vessels- propranolol. Patients with cardiogenic syncope are managed by a cardiologist. If necessary, the issue of implanting a cardioverter-defibrillator is resolved.

It should be noted that in all cases of syncope, treatment of patients necessarily includes therapy for concomitant and causative diseases.

Anna Mironova

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Fainting– protective reaction of the brain. It is by this method that the brain, feeling an acute lack of oxygen, tries to correct the situation. That is, it “lays” the body in a horizontal position to facilitate the work of the heart to supply blood to the brain. As soon as the oxygen deficiency is replenished, the person returns to normal condition. What are the causes of this phenomenon, what precedes fainting, and how to provide first aid correctly?

What is fainting, why is it dangerous and what causes it - the main causes of fainting

A well-known phenomenon - fainting is a loss of consciousness for a very short period, from 5-10 seconds to 5-10 minutes. Fainting that lasts longer is already life-threatening.

Why is fainting dangerous?

Single episodes of fainting are not inherently life-threatening. But there are reasons for alarm if you faint...

Is a manifestation of any dangerous disease(heart pathology, heart attack, arrhythmia, etc.).
Accompanied by head trauma.
Occurs in a person whose activities are related to sports, driving a car, flying an aircraft, etc.
Repeats from time to time or regularly.
Happens in an elderly person - without visible reasons and suddenly (there is a risk of complete heart block).
Accompanied by the disappearance of all swallowing and breathing reflexes. There is a risk that the root of the tongue, due to relaxation of muscle tone, will sink and block the airways.

Fainting – as a reaction to the smell of paint or the sight of blood, it is not as dangerous (except for the risk of injury during a fall). It is much more dangerous if fainting is a symptom of an illness or nervous disorder. Don't delay visiting the doctor. Necessary specialists– neurologist, cardiologist and psychiatrist.

There are many possible causes for fainting. The main, most common “triggers”:

A short-term sharp decrease in pressure.
Prolonged standing (especially if the knees are brought together, “at attention”).
Staying in one position for a long time (sitting, lying down) and suddenly rising to your feet.
Overheating, heat/sunstroke.
Stuffiness, heat and even too bright light.
State of hunger.
Extreme fatigue.
Fever.
Emotional stress, mental shock, fear.
Sharp, sudden pain.
Strong allergic reaction(for medications, insect bites, etc.).
Hypotension.
Reaction to medications with high blood pressure.
Arrhythmia, anemia or glycemia.
Ear infection.
Bronchial asthma.
The onset of menstruation (in girls).
Pregnancy.
Autonomic disorders nervous system.
A crowd, an impressive gathering of people.
Features of puberty.
Mental instability.
Reducing blood sugar (with diabetes or a strict diet).
Problems of cerebral circulation in old age.
Nervous and physical exhaustion.

Types of fainting:

Orthostatic syncope. It happens from a sudden change in body position (from horizontal to vertical). The cause may be insufficiency of the musculoskeletal system due to dysfunction of the nerve fibers involved in the vasomotor function. Fainting is dangerous due to falling and injury.
Fainting caused by prolonged immobility (especially standing). Similar to the previous type. It occurs due to the lack of muscle contraction and adequate blood flow through the vessels in the legs (blood cannot overcome gravity and reach the brain).
High altitude fainting. Occurs at high altitude due to poor blood supply to the brain.
"Simple" fainting(outside serious reasons): fogging of consciousness, drop in pressure, intermittent breathing, short-term loss of consciousness, very rapid return to normal state.
Convulsive fainting. The condition is accompanied by seizures and (often) redness/blueness of the face.
Bettolepsy. Short-term fainting in chronic lung disease, occurring due to a strong coughing attack and the subsequent outflow of blood from the skull.
Drop attacks. Dizziness, severe weakness and falling without loss of consciousness. Risk factors: pregnancy, cervical osteochondrosis.
Vasodepressor syncope. It occurs due to stuffiness, lack of sleep, fatigue, emotional stress, fear, etc. The pulse drops below 60 beats/min, and blood pressure drops sharply. Fainting can often be prevented by simply sitting in a horizontal position.
Arrhythmic syncope. A consequence of one type of arrhythmia.
Situational fainting. Occurs after defecation, constipation, diving, heavy lifting, etc. due to increased intrathoracic pressure and other factors.
Carotid sinus syndrome. Note that the carotid sinuses are extensions of the carotid arteries, the main suppliers of blood to the brain. Strong pressure on these sinuses (tight collar, sharp turn of the head) leads to fainting.
Fainting in the presence of cardiac arrhythmias. Occurs with severe bradycardia (heart rate less than 40 beats/min) or with paroxysmal tachycardia (180-200 beats/min).
Anemic fainting. Most often it occurs in older people due to a sharp decrease in hemoglobin, iron deficiency in the diet, or due to impaired iron absorption (when gastrointestinal diseases occur).
Drug-induced syncope. Happens
Occurs from drug intolerance/overdose.

Signs and symptoms of fainting - how to recognize a fainting person?

Doctors usually distinguish 3 states of fainting:

Presyncopal. The appearance of warning signs of fainting. The condition lasts about 10-20 seconds. Symptoms: nausea, severe dizziness, shortness of breath, ringing in the ears and sudden weakness, unexpected heaviness in the legs, cold sweat and darkening in the eyes, pale skin and numbness of the limbs, rare breathing, drop in blood pressure and weak pulse, “flies” before the eyes, grey colour skin.
Fainting. Symptoms: loss of consciousness, decreased muscle tone and neurological reflexes, shallow breathing, and in some cases even convulsions. The pulse is weak or not palpable at all. Pupils are dilated, reaction to light is reduced.
Post-syncope. General weakness persists, consciousness returns, and a sudden rise to the feet can provoke another attack.

Compared to other types of disturbance of consciousness, fainting is characterized by a complete restoration of the state that preceded it.

First aid rules for fainting - what to do if you faint, and what not to do?

First aid for a person who faints is as follows:

We eliminate (if any) the factor causing fainting. That is, we take (take) a person out of a crowd, a cramped room, a stuffy room (or we bring him into a cool room from the street), we take him out of the road, we take him out of the water, etc.
We provide the person with a horizontal, stable position– the head is lower than the body, the legs are higher (for blood flow to the head, if there is no head injury).
Lay on your side to prevent tongue retraction(and so that the person does not choke on vomit). If it is not possible to lay the person down, we sit him down and lower his head between his knees.
Next, you should cause irritation of skin receptors- spray the person’s face with cold water, rub ears, pat the cheeks, wipe the face with a cold wet towel, ensure air flow (unfasten the collar, belt, corset, open the window), let inhale ammonia (vinegar) - 1-2 cm from the nose, slightly moistening the cotton wool.
Wrap yourself in a warm blanket when low temperature bodies.

When a person comes to his senses:

You can't eat or drink right away.
You cannot immediately take a vertical position (only after 10-30 minutes).
If a person does not come to his senses:
We call urgently ambulance.
We check the free flow of air into the respiratory tract, pulse, and listen to breathing.
If there is no pulse or breathing, we perform an indirect heart massage and artificial respiration(“mouth to mouth”).

If you faint old man or a child, if there is a history of serious illnesses If fainting is accompanied by convulsions, loss of breath, if fainting happens out of the blue for no apparent reason, call an ambulance immediately. Even if a person quickly regains consciousness, there is a risk of a concussion and other injuries.

Fainting is caused by a temporary loss of blood supply to the brain and may be a sign of a more serious condition...

Temporary loss of consciousness - fainting

Fainting is a temporary loss of consciousness.

Fainting is caused by a temporary loss of blood supply to the brain and may be a sign of a more serious condition.

People of any age can faint, but older people may have more serious causes.

The most common causes of fainting are vasovagal (sharp decrease in heart rate and blood pressure) and heart disease.

In most cases, the cause of fainting is unknown.

Fainting can have many different causes:

Vasovagal syncope also known as "general weakness". This is the most common cause of syncope and is caused by an abnormal vascular reflex.

The heart pumps more intensely, the blood vessels relax, but the heart rate does not compensate quickly enough to maintain blood flow to the brain.

Causes of vasovagal syncope:

1) environmental factors(happens more often when it’s hot);

2) emotional factors (stress);

3) physical factors(load);

4) illness (fatigue, dehydration, etc.).

Situational fainting only occurs in certain situations.

Causes of situational fainting:

1) cough (some people faint when coughing too hard);

2) when swallowing (in some people, loss of consciousness is associated with illness in the throat or esophagus);

3) when urinating (when a susceptible person loses consciousness with a full bladder);

4) hypersensitivity of the carotid sinus (in some people when turning the neck, shaving or wearing a tight collar);

5) postprandial syncope can occur in older people when they blood pressure falls about an hour after eating.

Orthostatic syncope occurs when a person feels fine while lying down, but when standing up, may suddenly faint. Blood flow to the brain decreases when a person stands due to a temporary decrease in blood pressure.

This fainting sometimes occurs in people who have recently started taking (or have been changed to) certain heart medications.

Orthostatic syncope can be due to the following reasons:

1) low circulating blood volume caused by blood loss (external or internal blood loss), dehydration or heat exhaustion;

2) impaired circulatory reflexes caused by medications, diseases of the nervous system, or congenital problems. Cardiac syncope occurs when a person loses consciousness due to cardiovascular disease.

Cardiac causes of fainting are usually life-threatening and include the following:

1) abnormal heart rhythm - arrhythmia. Electrical problems in the heart impair its pumping function. This leads to decreased blood flow. Your heart rate may be too fast or too slow. This condition usually causes fainting without any warning.

2) cardiac obstructions. Blood flow may be obstructed in blood vessels in the chest. Cardiac obstruction can cause loss of consciousness during exercise. Various diseases can lead to obstruction (heart attacks, diseased heart valves during pulmonary embolism, cardiomyopathy, pulmonary hypertension, tamponade of the heart and aorta).

3) heart failure: the pumping ability of the heart is impaired. This reduces the force with which blood circulates through the body, which can reduce blood flow to the brain.

Neurological syncope may be associated with neurological conditions.

Its reasons are:

1) a stroke (bleeding in the brain) can cause fainting associated with headache;

2) a transient ischemic attack (or mini-stroke) can cause loss of consciousness. In this case, fainting is usually preceded by double vision, loss of balance, slurred speech, or dizziness;

3) in rare cases, migraine can cause fainting. Psychogenic fainting. Hyperventilation due to anxiety can lead to fainting. The diagnosis of psychogenic syncope should be considered only after all other causes have been excluded.

Symptoms of fainting

Losing consciousness is an obvious sign of fainting.

Vasovagal syncope. Before fainting, a person may feel light-headed; blurred vision will be noted. A person may see “spots before the eyes.”

The patient experiences pallor, dilated pupils, and sweating.

While unconscious, a person may have a low heart rate (less than 60 beats per minute).

The person must quickly regain consciousness. Many people do not have any warning signs before fainting.

Situational fainting. Consciousness returns very quickly when the situation passes.

Orthostatic syncope. Before an episode of fainting, a person may notice blood loss (black stools, heavy periods) or fluid loss (vomiting, diarrhea, fever). The person may also experience delusions. Observers may also note paleness, sweating, or signs of dehydration (dry lips and tongue).

Cardiac syncope. The person may report palpitations, chest pain, or shortness of breath. Observers may note the patient's weakness, irregular pulse, pallor, or sweating. Fainting often occurs without warning or after exertion.

Neurological syncope. The person may have a headache, loss of balance, slurred speech, double vision, or dizziness (the feeling that the room is spinning). Observers note a strong pulse during the unconscious period and normal skin color.

When to seek medical help?

Since fainting may be caused by a serious condition, All episodes of loss of consciousness should be taken seriously.

Anyone, even after the first episode of loss of consciousness, should consult a doctor as soon as possible.

Depending on what was shown medical checkup, the doctor may require tests.

These tests may include: blood tests; ECG, 24-hour monitoring, echocardiography, functional load test. Table tilt test. This test checks how your body reacts to changes in position. Tests to detect nervous system problems (head CT scan, brain MRI or EEG).

If the person next to you faints, help him.

Place it on the ground to minimize the chance of injury.
Encourage the person actively and call an ambulance immediately if the person is unresponsive.
Check your pulse and begin CPR if necessary.
If the person is recovering, let him lie down until the ambulance arrives.
Even if the cause of fainting is not dangerous, have the person lie down for 15-20 minutes before getting up.
Ask him about any symptoms such as headache, back pain, chest pain, shortness of breath, abdominal pain, weakness or loss of function, because these may indicate life-threatening causes of fainting.

Treatment of fainting

Treatment for fainting depends on the diagnosis.

Vasovagal syncope. Drink plenty of water, increase your salt intake (under medical supervision), and avoid standing for long periods of time.

Orthostatic syncope. Change your lifestyle: sit down, bend over calf muscles for a few minutes before getting out of bed. Stay hydrated.

Elderly people with low blood pressure Large meals should be avoided after meals or you should plan to lie down for several hours after eating. In most cases, you should stop taking the medications that cause fainting (or change them).

Cardiac fainting. To treat cardiac syncope, the underlying condition must be treated.

Valvular heart disease often requires surgery, while arrhythmia can be treated with medications.

Medications and lifestyle changes.

These procedures are designed to optimize cardiac performance and monitoring is necessary. high pressure blood; in some cases, antiarrhythmic drugs may be prescribed.

Surgery: bypass surgery or angioplasty are used to treat coronary disease hearts; in some cases the valves may need to be replaced. A pacemaker may be implanted to normalize the heart rate (slows the heart for fast arrhythmias or speeds up the heart for slow arrhythmias). Implanted defibrillators are used to control life threatening fast arrhythmia.

Preventing fainting

Preventive measures depend on the cause and severity of the fainting problem.

Fainting can sometimes be prevented by taking simple precautions.

If you are weak due to the heat, cool down your body.
If you faint while standing (after lying down), move slowly while standing. Slowly move to a sitting position and rest for a few minutes. When you are ready, stand up using slow and fluid movements.

In other cases, the causes of fainting may be subtle. That's why Consult your doctor to determine the cause of fainting.

Once the cause is determined, treatment for the underlying disease should begin.

Cardiac syncope: because of high risk death from cardiac syncope, people who experience it must be treated for the underlying illness.

Periodic fainting. Consult a doctor to determine the reasons for frequent loss of consciousness.

Prognosis due to fainting

The prognosis for a person who has fainted depends largely on the cause, the patient's age, and available treatments.

Cardiac syncope has the greatest risk of sudden death, especially in older people.
Fainting, which is not associated with cardiac or neurological disease, represents a more limited risk than in the general population.

Checking the pulse in the neck area. The pulse can be clearly felt only near the throat (trachea).

If the pulse is felt, note whether it is regular and count the number of beats in 15 seconds.

To determine your heart rate (beats per minute), multiply this number by 4.

The normal heart rate for adults is between 60 and 100 beats per minute.

If fainting happened just once, then you don’t have to worry about it.

It is important to see a doctor because fainting can have serious causes.

Fainting may be a sign of a serious problem if:

1) it often occurs over a short period of time.

2) it occurs during physical exercise or vigorous activity.

3) fainting occurs without warning or in a supine position. When fainting is not serious, the person often knows it is about to happen and vomits or feels sick.

4) a person loses a lot of blood. This may include internal bleeding.

5) shortness of breath is noted.

6) chest pain is noted.

7) a person feels that his heart is pounding (palpitations).

8) Fainting occurs along with numbness or tingling in one side of the face or body. published .

If you have any questions, please ask

The materials are for informational purposes only. Remember, self-medication is life-threatening; consult a doctor for advice on the use of any medications and treatment methods.

Syncope (fainting) manifest themselves as a sudden short loss of consciousness and are accompanied by a sharp decrease in muscle tone. Brief loss of consciousness is a fairly common occurrence. Statistics say that almost every third person living on Earth has fainted at least once in their life.

Classification of the disease

According to pathophysiological characteristics, fainting is classified into the following types:

cardiogenic (heart);
reflex;
orthostatic;
cerebrovascular.

Cardiogenic syncope arise as a result of the development of various cardiovascular pathologies, resulting in morphological and structural changes in the functioning of organs (vessels and heart). Depending on the type of pathology, cardiogenic syncope is in turn divided into obstructive and arrhythmogenic.

Reflex fainting Unlike cardiogenic syncope, they are not associated with diseases of the cardiovascular system; the causes of their occurrence are sudden psycho-emotional disorders. There are vasovagal syncope and situational syncope. Vasovagal syncope is the most common, and sudden “lightheadedness” can occur at any age. Vasovagal syncope usually occurs when the body is in an upright position or when sitting position. Often observed in young people who do not have health problems. Situational syncope can happen when swallowing, when coughing or sneezing, or when defecating or urinating.

Orthostatic collapse associated with the occurrence of lability or insufficiency of vasoconstrictor reflexes. Orthostatic fainting occurs when there is a sudden change in body position from horizontal to vertical. Most often, orthostatic collapse occurs at night or in the morning as a result of abruptly getting out of bed. It can also occur with prolonged standing. Vascular syncope is caused by insufficient tone of the venous system. When changing body position, a sharp redistribution of blood flow occurs, the amount of blood volume in the venous bed increases, and the blood flow to the heart, on the contrary, decreases. Orthostatic hypotension accompanied by a sudden drop in arterial and venous pressure.

Cerebrovascular syncope- these are, in essence, ischemic transient attacks associated with the venous distance and arising in the vertebrobasilar system. Fainting conditions caused by vertebrobasilar insufficiency are quite rare and are most often observed in elderly people over 60 years of age.

Symptoms and signs

New syncope can be a manifestation of a dangerous, life-threatening disease: myocardial infarction, subarachnoid hemorrhage, heart rhythm disturbances, pulmonary embolism, internal bleeding.

Typical signs of fainting:

Profuse sweating;
dizziness;
tinnitus;
nausea;
flickering or darkening in the eyes;
cardiopalmus;
hot flashes;
pale skin.

A pre-fainting state is manifested by accelerated breathing and increased yawning, thus the body tries to make up for the lack of oxygen to nourish the brain. Then drops of sweat appear on the forehead, the skin turns pale.

When you faint, blood pressure decreases, weakness appears, and breathing becomes shallow. The time spent in an unconscious state can last from one moment to several minutes. In some cases, fainting may be accompanied by convulsions.

Causes of the disease

Fainting may be caused various disorders in the functioning of the body - somatic, psychogenic, neurological. Most often, an attack of loss of consciousness is caused by a narrowing of blood flow to the brain. Blood flows to the organ in insufficient volume, which leads to oxygen starvation.

Main causes of fainting:

Problems in the functioning of the cardiovascular system;
chronic lung disease and a number of other diseases;
sugar deficiency;
hunger;
pain;
pregnancy;
large blood loss;
stressful situation or shock.

The cause of fainting can be heatstroke, which can provoke heat air along with high humidity.

One of the causes of fainting is hypersensitivity of the carotid sinus. Sudden fainting can occur when exposed to the arterial bed in the bifurcation zone of the main carotid artery, for example, when massaging the specified area. Fainting caused by increased sensitivity of the carotid sinus occurs more often in men than in women, and if a man is elderly, then the risk of this type fainting increases significantly.

Fainting in children is often caused by vegetative-vascular dystonia, which leads to a drop in venous and blood pressure. They are more often observed in children with increased emotional lability. A child who has suffered a severe infectious disease is also susceptible to fainting due to weakening of the body and loss of appetite.

People on strict diets are at risk of fainting from hunger. A girl who strictly limits her diet in order to acquire an ideal figure, receives less necessary for the body nutrients. Energy deficiency occurs and the body reduces blood flow to digestive organs, ensuring the functioning of the heart, brain, lungs. If there is insufficient blood flow to the vital important bodies the brain shuts down and loss of consciousness occurs. The consequences of hungry syncope can be quite sad - traumatic brain injuries, lack of coordination, memory gaps, etc.

Syncope during pregnancy occurs due to low blood pressure. A sharp jump in blood pressure in pregnant women can be associated with stuffiness, overwork, hunger, and exacerbation of chronic and respiratory diseases, with emotional experiences.

Diagnosis and treatment

Diagnostic measures for fainting are based on:

On studying the patient's history and complaints,
on laboratory examinations;
on additional diagnostic methods.

Laboratory research allow you to determine the amount of glucose, red blood cells and hemoglobin in the blood. TO additional funds diagnostics include:

electrocardiography– study of the heart using electrodes applied to the body;
dopplerography– examination of blood vessels to determine the permeability of blood flow to the brain and identify existing deformations;
spiral CT angiography– giving an idea of the structure of the atherosclerotic plaque, stenosis. This method The study makes it possible to assess blood flow during dosed physical activity, which includes bending, turning and tilting the head, and also to determine the relationship of the skull, vertebral arteries and vertebrae.

Brief data
- It is known that in the 18th and 19th centuries, young ladies and ladies of noble birth quite often lost consciousness. The cause of fainting was the universal wearing of corsets.
- In almost 50% of cases of syncope, it is not possible to determine the real cause of fainting.
- According to statistics, about half a million new cases of fainting are registered every year around the world. Among adolescents and children, the number of cases of short-term loss of consciousness is about 15% out of 100; people over 70 years old account for 23%. Short-term fainting in men aged 40 to 59 years is observed in 16% of cases, and in women, indicated age category – 19%.

Fainting is not so safe. If a person is not brought to consciousness in time, a simple fainting spell can be fatal.. First urgent Care should consist of giving the unconscious person a body position that will ensure maximum blood flow to the brain. So, for example, if a person is in a sitting position, then he should be laid on a flat surface, with his head lowered between his knees and raised lower limbs. Fainting may be accompanied by vomiting, so the patient's head should be tilted to the side to prevent aspiration.

It is important to ensure that during an unconscious state the tongue does not sink in and block the airway. It is necessary to provide additional air access; to do this, you need to stretch the clothing that is constricting the body (collar, belt, etc.). If fainting occurs indoors, you should open the windows.

To bring a person to consciousness, irritating influences are often used - ammonia is brought to the patient’s nose, the neck and face are sprinkled with cold water. After the patient has come to his senses, you need to observe him for some time - until the feeling of weakness completely disappears.

If it is not possible to bring a person to consciousness within five minutes, you need to call an ambulance. Deep fainting is a very dangerous phenomenon, especially if the syncope is accompanied by bluishness of the facial skin; in most cases, patients do not survive.

Medical practice in the treatment of fainting uses drugs such as 10% cordiamine, or corazol in a dosage of 1 ml, 10% caffeine benzoate solution. Medications are administered subcutaneously. To more quickly restore blood pressure, use a 5% ephedrine solution. If after the measures taken the effect is not achieved, doctors carry out such actions as artificial respiration, accompanied indirect massage hearts.

Prevention

Prevention of fainting involves avoiding circumstances in which loss of consciousness may occur, i.e. stressful situations, hunger, excessive fatigue, etc. Increased physical activity can provoke fainting, so a young guy working out in the gym for several hours in a row risks losing consciousness from physical exhaustion.

Preventive measures include moderate exercise, hardening, normal work, sleep and rest.

In the morning, when getting out of bed, you should not make sudden movements, since a rapid transition from a lying position to a standing position can lead to orthostatic collapse.

Traditional methods of treatment

One of the most popular folk methods for treating fainting conditions is sweet coffee or Herb tea(mint, chamomile), it is also recommended to drink a small amount of cognac or wine.

With frequent fainting caused by psycho-emotional experiences, ethnoscience recommends drinking teas with lemon balm, linden, and St. John's wort.

Frequent fainting traditional healers They suggest treating with a decoction of gentian. To prepare it you should take 2 tsp. chopped herbs and pour two glasses of boiling water over them. It is necessary to take the miraculous remedy three times a day, in a dosage of ½ glass, preferably before meals.

To prevent frequent fainting, you can use the following remedy: grind 1 tbsp in a coffee grinder. a spoonful of wormwood seeds, add to the mixture olive oil in a volume of 100 ml and leave for ten hours. Transfer the prepared medicine into a dark glass jar and store it in the refrigerator. Directions for use: a couple of drops medicinal mixture drop on a refined piece of sugar, take twice a day.

To bring a person to consciousness, traditional medicine suggests using essential oils– rosemary, mint, camphor.

You can bring a person to consciousness by applying to the zone solar plexus crushed burdock leaf. A wax ointment, which has cooling properties, is applied to the crown of the patient.

A special massage will also come to the aid of a sick person. Providing assistance consists of massaging the pads of the fingers, kneading the earlobes, and massaging certain points. One of them is located under the nasal septum, the other is in the center of the fold under the lower lip.

Fainting, or syncope, is an attack of short-term loss of consciousness with a violation of muscle tone, cardiovascular activity and respiratory systems. Fainting is not a disease, but only a symptom of some condition of the body, and the cause is not always a disease. The main mechanism for the development of fainting is considered to be a sudden decrease in blood supply to the brain. Despite the many reasons leading to fainting, it clinical picture Quite the same type (with minor features). In this article we will talk about how fainting manifests itself, the main types of fainting and their treatment.

Fainting is very common. Almost a third of the world's population has experienced syncope at least once in their lives. The prevalence of fainting increases with age, this is especially noticeable after 65 years (in this age category the frequency increases by 2 times). But children, on the contrary, very rarely suffer from such conditions.

Why does fainting occur?

The main cause of fainting is considered to be a transient decrease in blood circulation in the brain. As a result, brain structures such as the reticular formation and the cerebral cortex do not receive enough nutrients and energy. The reticular formation keeps the entire body in good shape through an activating effect on the cerebral cortex and reflex activity. Of all the brain structures, it is the most sensitive to nutritional deficiency, so it is the first to react to a sudden change in blood flow. Due to dysfunction of the reticular formation, the balance between the sympathetic and parasympathetic departments is disturbed, with the latter predominant. The sharp superiority of parasympathetic influences realized through the vagus nerve becomes the cause of all the symptoms of fainting.

Fainting is a very short-term condition because it is accompanied by a decrease in muscle tone and a fall, as a result of which the person assumes a horizontal position. In this position, sufficient blood flow to the brain is restored, and all symptoms disappear. For the same reason, if you have time to take a horizontal position when it becomes bad, you can avoid the development of fainting.

Symptoms of fainting

An attack of fainting is divided into several stages:

presyncope, or lipothymia;
actual fainting;
post-fainting state.

The lipothymic state occurs immediately a few tens of seconds before loss of consciousness (most often it lasts from 4-20 seconds to 1-1.5 minutes). At this moment, a person feels a feeling of nausea (lightheadedness), dizziness, noise or ringing in the ears, blurred vision (“fog”, “veil”, “floaters before the eyes”). There is a growing weakness that rolls in like a wave. The legs become “wobbly” and unruly, the skin becomes covered with cold sweat, the face turns pale. In some patients, parallel to these symptoms, a feeling of anxiety or fear, palpitations, a feeling of lack of air or a lump in the throat, numbness of the fingertips, tongue, lips, and yawning appear. Sometimes this is the only thing that can limit an attack, that is, the loss of consciousness itself will not occur, especially if the patient manages to assume a horizontal position. In rare cases, syncope occurs without a previous lipothymic condition (eg, cardiac arrhythmias, syncope when swallowing). This stage ends with a feeling of “the ground floating away from under your feet.”

The stage of fainting itself is characterized by loss of consciousness. Simultaneously with the loss of consciousness, muscle tone throughout the body sharply weakens, so patients often seem to smoothly “slide” to the floor, rather than fall like tin soldiers. If fainting suddenly develops, bruises may occur if you fall. Typically, loss of consciousness lasts 5-60 seconds. During the absence of consciousness, the skin becomes pale gray, ashy, and even greenish color, become cold to the touch, blood pressure drops (systolic reading 60 mmHg and below), pulse becomes weak, thready, breathing is shallow (it may even seem that the person is not breathing), all deep reflexes decrease, pupils dilate and react poorly to light (that is, they almost do not narrow, as is normal). If blood flow to the brain is not restored within 15-20 seconds, involuntary urination and defecation, as well as several muscle twitches, may occur.

The post-syncope period lasts only a few seconds until consciousness is fully restored. The restoration of consciousness occurs gradually: vision seems to turn on, the voices of others appear, initially sounding in the distance, sensation returns own body. These sensations actually take a few seconds, but the patient himself remembers them as if they were in slow motion. After complete restoration of consciousness, patients immediately become oriented in place, time, and their own personality. Of course, the first reaction is fear at what happened. Heartbeat and breathing quicken, you feel tired and weak, sometimes discomfort in the abdomen and heart. The patient does not remember the second period of fainting, that is, the last memories are associated with a sudden deterioration in health.

The severity of fainting is determined by the duration of the period of loss of consciousness and the severity of disturbances in vital functions.

Types of fainting

There is no generally accepted classification of fainting in medicine. One of the most rational, perhaps, is the following classification. So, fainting occurs:

neurogenic;
somatogenic;
extreme;
multifactorial.