Treatment of Syncope

Syncope (fainting) is a common symptom of many diseases, usually heart conditions or neurological disorders. Up to 30% of the population has lost consciousness at least once during their lifetime, and 25% have recurring episodes of syncope. Every year, over half a million episodes of loss of consciousness are recorded in the world, and 15% of them occur in children under 18 years of age. You can undergo your syncope treatment abroad. You are welcome to visit the Booking Health website to find out the cost of treatment and choose a medical care program.

Content

1. Causes
2. Treatment of syncope in neurology
3. Treatment of syncope in cardiology
4. Where to seek medical attention for the treatment of syncope?

Causes

According to the definition of the European Society of Cardiology, syncope is a transient loss of consciousness caused by a temporary restriction of blood supply to the brain. Syncope develops rapidly but is of short duration. A person regains consciousness spontaneously without any medical attention.

The reasons for the development of syncope are quite numerous. The origin of syncope can be cardiogenic, psychogenic, carotid sinus (reflex), heat, or orthostatic hypotension (a drop in blood pressure when switching from a horizontal to a vertical position) and Adams-Stokes syndrome (due to heart block).

The most common cause of fainting is a change in vascular tone (18% of cases). In second place are heart arrhythmias (14%). The third place is occupied by situational syncope (8%), for example, due to blood loss, high physical activity, etc. All other causes are much less common. In a third of patients, the reason remains unknown.

Treatment of syncope in neurology

In neurology, syncopes are most often vasovagal. They are associated with changes in the tone of the vagus nerve and vascular tone, with bradycardia (low heart rate), and are due, on the one hand, to the characteristics of the body and, on the other hand, to external provoking factors (prolonged standing, fear, pain, type of blood, etc.). 

Such fainting is usually not dangerous, except for the threat of injury from a fall. They do not indicate any illness. Treatment of syncope that happened once is not required. If fainting recurs, however, the help of doctors from the department of neurology is necessary for a patient.

Therapy involves the use of conservative methods. A patient receives recommendations for lifestyle correction. These may be as follows:

• fluid intake of up to 2-3 liters per day to maintain blood pressure, which is necessary for adequate blood delivery to the brain;
• drinking coffee and other tonics (ginseng, magnolia vine, etc.);
• good sleep;
• sufficient physical activity; 
• reduced alcohol consumption; 
• quitting smoking;
• elimination of provoking factors, such as baths, saunas, prolonged standing, hard physical labor, etc.

If there are any signs of fainting, a person should assume a horizontal position and drink cold water if possible. Daily orthostatic training (tilt training) is necessary for long-term relief of symptoms of the condition. If non-pharmacological measures do not help in the treatment of fainting, drug therapy will be an option of choice.

Treatment of syncope in cardiology

If episodes of loss of consciousness in neurology only violate the quality of life, in cardiology they are considered a dangerous condition, with the threat of sudden cardiac death. The reasons for syncopes may be as follows:

• a cardiac arrest lasting several minutes;
• a decrease in heart rate to 20-30 beats per minute.

Loss of consciousness and presyncope are most often associated with Mobitz type 2 or 3 second-degree atrioventricular block (AV block). This disease is characterized by a poor passage of electrical impulses from the atria to the ventricles.

Patients with second-degree blocks have their impulses blocked from time to time, and when this happens, the heart needs time to "switch" to the backup pacemaker. While this is happening, the heart does not work, the brain does not receive blood, and the person loses consciousness.

In the case of the third-degree AV block, no impulses pass from the atria to the ventricles at all (complete AV block). The ventricles contract in their own rhythm, and this occurs very slowly. Stress, physical activity or other factors can therefore lead to the fact that circulatory decompensation occurs. The brain does not have enough blood, and the person loses consciousness. A state of rest sets in, the body's need for oxygen decreases, and after a few minutes, the person regains consciousness.

There are also other arrhythmias that reduce the heart rate. All of them are diagnosed using an electrocardiogram (ECG). In addition, an ECG can determine the severity of the disease and help deciding on the best treatment options.

Typically, the treatment of syncope in such situations involves the implantation of an artificial pacemaker, which will maintain a normal heart rate. Treatment abroad is effective and minimally traumatic. During a minor surgical procedure, electrodes are inserted into the heart through the blood vessels, and an electrical impulse generator itself is placed in the subcutaneous fat layer of the chest. As a result, the heart rhythm returns to normal, and fainting stops.

Where to seek medical attention for the treatment of syncope?

You can undergo your diagnostics and treatment abroad. You are welcome to use the Booking Health service to find out the cost of treatment and choose a medical care program at the best price.

You will be examined in the departments of neurology or cardiology to find out the reasons for your fainting. The diagnostics involve a clinical examination, functional tests (a tilt test and carotid sinus massage), blood pressure measurement, ECG, and echocardiography. The diagnostic examination will be followed by the treatment of syncope, which depends on the detected disease.

The Booking Health website presents the best hospitals in the world where you can receive top-class medical care. On our website, you can see the cost of treatment, sort clinics by price, rating, or reviews. The specialists from the Booking Health company will help you choose the most suitable hospital. They will also take care of all the arrangements for your treatment abroad.

When making your appointment through Booking Health, the cost of treatment of syncope will be lower for you than when you contact the medical center directly. Prices are reduced due to the absence of taxes for foreign patients.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

IMTJ - International Medical Travel Journal

UpToDate

MedicineNet