What is meant by the medical term syncope?

By Cristiano Antonino Last updated Jun 19, 2023

Fainting, drop in blood pressure, loss of consciousness: syncope is defined in many different ways. Defining syncope is not easy, but we could compare it to a total ‘blackout’ of our body, in which we literally ‘switch off’

Usually syncope is benign in nature, occurs suddenly and resolves quickly and spontaneously.

In this article, let’s take a look at the causes of syncope, how to recognise it, therapies to deal with it, what to do if it occurs frequently, and other interesting facts about this phenomenon of the body.

But what exactly is syncope?

Syncope is a phenomenon that occurs as a result of cerebral hypoperfusion.

If you are wondering whether there is a way to prevent it, the correct answer is ‘it depends’.

It depends because, while it is true that syncope can be absolutely transient, it may be anticipated by certain symptoms that act as an ‘alarm bell’.

These symptoms, if caught quickly, may help the person to take cover or help those around him or her to avoid potentially dangerous consequences such as a head injury.

Prodromal symptoms of syncope

Prodromal – i.e. premonitory – symptoms include:

sudden nausea
excessive and unmotivated sweating;
cold sweating;
dizziness;
asthenia.

As already mentioned, syncope can also be sudden and lightning-fast and not be preceded by any of the symptoms described above.

But let us take a closer look at what causes syncope.

The main causes of syncope

Syncope can be, as illustrated, the alarm bell of a more serious problem.

It is possible that an episode of syncope is a consequence of heart disease and, in this case, a cardiological check-up is necessary as soon as possible to avoid more serious repercussions or fatal syncope.

What to do if someone has syncope

Although the recovery of the person suffering from sudden syncope may be rapid, it is always a good idea to go immediately to the emergency department to investigate the cause of the syncope.

If it is the antechamber of a heart disease, it should be detected and treated as soon as possible with the help of a specialist.

How it is diagnosed

If you have experienced an episode of syncope, you should immediately contact your general practitioner or go to the hospital for a check-up.

A thorough medical history, together with blood pressure measurement and evaluation of any pre-existing conditions, will help in the diagnosis.

In addition to the objective examination, the specialist may deem it necessary to perform further tests, such as an exercise test, electrophysiological study, echocardiogram or ECG monitoring.

Types of syncope

But is syncope always the same? In reality, no, since at least three types are distinguished in the medical literature.

There is neuromediated syncope (the most common), orthostatic hypotension syncope and cardiac syncope.

In the case of cardiac syncope, this may be generated by heart disease, myocardial infarction or pulmonary embolism.

Neuromediated syncope, also referred to as vasovagal syncope, is linked to an inappropriate functioning of the autonomic nervous system leading to alterations in blood pressure and frequency.

As mentioned, neuromediated syncope is the most common and consequence-free syncope and can be triggered by any stressful event (trauma, fright, etc.).

Indeterminate syncope

In addition to those listed above, mention must also be made of syncopes of an indeterminate nature.

Indeterminate syncopes are those without apparent justification or, in any case, that are not fully answered by the anamnesis, diagnostic tests and blood tests.

Exertional syncope

Exertional syncope is more common than it appears and represents a ‘blackout’ episode in which the subject may faint following great physical exertion.

Think about running at breakneck speed without the right training, lifting an extremely heavy object, inflating a balloon without catching your breath… All syncopes that occur after great physical exertion are usually benign in nature but, nevertheless, the necessary investigations must be carried out to rule out the presence of other pathologies.

Are there any prevention methods for syncope?

Syncope may be an isolated and entirely unpredictable episode or a series of episodes occurring over time.

In this case, certain measures can be taken to prevent or reduce the onset of syncope.

One of the most important of these is to avoid sudden movements (e.g. getting out of bed too quickly or, more generally, moving abruptly to an upright position).

Moving slowly helps to keep blood pressure under control, as does drinking enough water and adopting a healthy lifestyle both nutritionally and physically.

Constant physical activity is extremely important to keep the body active and healthy.

Syncope and sudden death: what are the correlations?

In rare cases, syncope, rather than taking the form of an isolated, benign episode, can present itself as sudden death.

This occurs especially in extremely severe cases, such as ischaemic heart disease or undiagnosed congenital heart disease.

This is why it is important that all individuals, even asymptomatic ones, especially those with a family history of heart disease, undergo regular cardiological check-ups.

Who are the patients most at risk

Certainly those with some kind of heart problem and, as is often the case, those most at risk are confirmed to be elderly patients.

However, very young people may experience an episode of syncope in their life that is usually isolated and benign.

Sports syncope: the collapse

Sports syncope is very common in those who engage in competitive or fitness activities on a continuous basis.

It is one of the additional aspects of exertional syncope, which can lead to the athlete or trainee suddenly collapsing.

In sports syncope, it is necessary to immediately ascertain the patient’s condition: if the patient is alert and responsive, there is no need for alarm.

In the case of a loss of consciousness, on the other hand, it is advisable to assess the presence of breath and heartbeat, promptly alerting help and, if necessary, initiating cardiopulmonary resuscitation manoeuvres.

In the event of spontaneous recovery of consciousness, it is still necessary to go immediately to the nearest hospital facility.

In general, it is always a good idea to monitor the individual’s heart rate and blood pressure, if possible.