The term syncope comes from the Greek, synonyms are, for example, circulatory collapse and blackout. Similar symptoms are manifested in unconsciousness, dizziness and circulatory problems.
What is circulatory collapse?
Acute circulatory collapse, also known as syncope in professional circles, is a spontaneous loss of consciousness that lasts a short time and is reversible. Acute circulatory collapse, also known as syncope, is a spontaneous and brief loss of consciousness that is reversible. The accompanying symptom of circulatory collapse also consists of the additional loss of so-called postural control. Syncope is often confused with loss of consciousness or neurologic seizures. Hypoglycemia (low blood sugar) is also not part of the syncope group.
Causes
The cause of syncope is partly the result of impaired blood flow affecting the brain. In more frequent cases of circulatory collapse, there may be several underlying causes, which should be clarified by taking an appropriate and detailed medical history. Causes may include evidence of myocardial infarction, pacemaker syndrome, valvular defects, psychogenic syncope, visceral reflex syncope, drug-induced syncope, cardiac arrhythmias, cerebral artery stenosis, antiarrhythmic drugs, reflex syncope in the presence of aortic stenosis, atrial myxoma and antihypertensive drugs, carotid sinus syncope. A distinction is made from purely circulatory syncope a present loss of consciousness based on other causes, such as: in a seizure, hypoglycemia, narcolepsy, a cerebrally caused or even metabolically caused loss of consciousness.
Diseases with this symptom
- Heart attack
- Heart valve defect
- Diabetic neuropathy
- Cardiac arrhythmias
- Antiarrhythmics
- Cardiomyopathy
- Seizures
- Narcolepsy
- Hypoglycemia
Diagnosis and course
In the listed syncope, a clinical differential diagnosis from the “real” present syncope is extremely difficult to distinguish, because in order to make a basic diagnosis, it basically requires further investigations. The anamnesis plays a decisive role in the exact diagnosis of syncope. Among other things, the following should be clarified: the general health background of the patient, the circumstances possibly underlying the syncope, and the clarification of the question of whether a metabolic disease or a heart disease is possibly present. Furthermore, previous diseases in the neurological field should be investigated and finally the medication intake plays a decisive role. Diagnosis is often difficult due to the transient and sporadic occurrence, i.e. the short-term nature of the syncope. The investigative procedures used include a long-term ECG, electrocardiogram (EEG), imaging, double sonography, the performance of clinical testing procedures, MRI, Schellong test, CT, and others.
Complications
Circulatory collapse, also known as syncope, involves a brief loss of consciousness, which can carry various complications depending on the cause. First, circulatory collapse can result from various triggers, such as the sight of blood or a fright. However, after a few seconds, the affected person usually regains consciousness and no further consequences occur. However, if the collapsing person falls, he or she may sustain severe injuries, especially to the head, resulting in traumatic brain injury. In carotid sinus syndrome, receptors that measure blood pressure are hypersensitive and can be activated by even the slightest touch stimuli, leading to circulatory collapse. However, affected individuals usually regain consciousness quickly. In the rarest cases, activation can lead to cardiac arrest and death of the patient. Cardiac arrhythmias can also trigger syncope, both when the heart beats too slowly (bradycardia) and too fast (tachycardia). The brain receives insufficient blood flow due to the irregular heartbeat and does not get enough oxygen. Such cardiac arrhythmias can lead to a wide variety of complications.It is not uncommon for those affected to suffer from cardiac insufficiency. In addition, a heart attack can also trigger a collapse. This also leads into heart failure, but also often leads to the death of the patient.
When should you go to the doctor?
Any circulatory collapse is a reason to see a doctor immediately. At best, the patient does not sustain any injuries in the process and is quickly back on his or her feet, but as good as this is, it does not explain why the circulatory collapse could have occurred. Therefore, there is a risk that a new circulatory collapse will occur and that worse things will happen the next time. At best, an ambulance is called to the affected patient, because even when going to the doctor, it can happen that the circulation weakens again. The case is particularly urgent if the affected person does not wake up himself after a few minutes or even stops breathing during a circulatory collapse. In these serious cases, it is essential not to wait until a doctor arrives. If the person is lying unconscious on his back, there is a risk that he may swallow his tongue and suffocate. In this case, the person should be turned onto his side, preferably in the stable lateral position, until the emergency physician arrives. If breathing stops, cardiopulmonary resuscitation must be performed, otherwise the patient will not survive at all or only with severe brain damage until a doctor arrives. If the patient is breathing but still unconscious, he or she must be placed in the recovery position to continue breathing. At best, two healthy people can work together, with one calling 911 and another providing first aid and talking to the patient once he or she wakes up after circulatory collapse.
Treatment and therapy
A therapy of syncope is carried out according to the diagnosed causes. For example, depending on the diagnosis present, cardiac medications, individualized cardiovascular training and means to increase blood pressure are available. If an unexpected and unannounced fainting attack occurs, initial measures such as raising the legs of the affected person slightly and possibly covering him or her up are helpful. Under no circumstances should a patient get back up immediately after surviving a fainting spell. A few minutes of rest and lying down will help to stabilize the circulation. If the patient does not regain consciousness immediately despite the measures taken, an emergency physician should be notified. Syncope can often be prevented by prevention with training. Although most types of syncope do not occur frequently, if they do affect people, this is not only unpleasant but, depending on the situation, can be dangerous both for the person affected and for others. This applies, for example, to driving a car. Here, the affected person is extremely endangered, but also other road users by a sudden fainting, states of weakness due to low blood pressure or even brief disturbances of consciousness, which may cause the affected person to lose control of his vehicle and thus lead to traffic accidents sometimes serious outcome.
Outlook and prognosis
In circulatory collapse, the prognosis depends primarily on the severity of the syncope and the patient’s general health. Circulatory collapse may occur once and be recovered without complications. Long-term sequelae are rare, but may occur if the affected person already has cardiovascular disease or the collapse results in an accident. The prognosis is also less positive in the case of circulatory collapse as a result of dehydration, deficiency symptoms or myocardial infarction: affected individuals often continue to suffer from typical symptoms of exhaustion and the direct consequences of circulatory collapse for a long time. If the underlying condition is treated effectively, there is a chance of full recovery. For example, circulatory training can greatly reduce the risk of further syncope, while medications and surgical interventions improve the patient’s overall constitution, contributing to a positive prognosis. Circulatory collapse secondary to trauma may require therapeutic intervention and can also be effectively treated. The prospect of complete recovery is thus generally given in the case of circulatory collapse, provided that the underlying condition is treated quickly and no permanent damage has yet been caused by the condition in question.
Prevention
To prevent circulatory collapse, researchers at the University of Amsterdam have developed a method that is easy to perform for all affected individuals and have subjected it to a review by means of a corresponding study. This method was named “Counterpressure Maneuvre (short form: PCM). In German this means as much as physical counterpressure massages. As mentioned, these exercises are simple and can be performed by anyone. They are also proven to be good for prevention. The PCM method is performed by crossing the legs, tensing the muscles. Alternatively, the arm muscles should be tensed or hooking and spreading both hands apart should be done. Since PCM exercises are easy to perform, whenever sufferers feel that syncope is imminent, they should immediately perform the mentioned exercises, which are also reminiscent of the so-called isometric training. The result of the training performed should be an increase in blood pressure. Since there is currently no better therapy or prevention in the world, the first choice is PCM. In a basic study of patients between 16 and 70 years of age, the scientists tested whether this method can prevent syncope that occurs in everyday life. Since no better therapies and measures currently exist, PCM is the first choice. The physicians tested whether vasovagal syncope can be prevented in everyday life with 223 patients between 16 and 70 years of age who suffer from recurrent syncope and experience preceding symptoms. To validate accuracy, they divided the subjects into two groups. All patients were educated about syncope and given lifestyle modification advice. In one group, however, patients were additionally taught PCM exercises. After a period of 14 months, the study concluded that syncope occurred in about 50.9 percent of patients with no training, while the percentage in the group with which training was done regularly was only 31.6 percent.
Here’s what you can do yourself
In the event of circulatory collapse, a doctor should always be consulted immediately. While it is possible to avoid circulatory collapse by performing certain procedures, an emergency physician should always be called or the hospital visited when it occurs. If circulatory collapse occurs, the patient must first and foremost be placed in the recovery position. If breathing is not functioning, the patient must also be artificially ventilated by mouth-to-mouth resuscitation until the emergency physician arrives. If unconsciousness does not occur during circulatory collapse, the affected person should definitely lie down and raise his legs. This will get the blood to the head and to the important organs. In any case, a high intake of fluids is necessary to prevent circulatory collapse. This is especially true on hot summer days and during sustained athletic activity. Likewise, a healthy lifestyle has a positive effect on circulatory collapse and can prevent it. Older people should not perform strenuous work in summer and should wear only light clothing so that the body can dissipate the heat well. Should a circulatory collapse occur, the body must be spared afterwards. This includes, above all, bed rest. The patient should refrain from alcohol and cigarettes in any case.
