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Synkope
Usually a brief drop in circulation and harmless — but during exercise or without warning, always investigate.
Also known as: syncope · faint · passing out · blackout
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A brief loss of consciousness happens when the brain briefly gets too little blood. The most common is the harmless circulatory faint (vasovagal syncope): from long standing, heat, pain, fright or the sight of blood — often with warning signs like dizziness, nausea, sweating and vision going dark. Standing up too fast (a drop in blood pressure), lack of fluids or certain medicines can also be behind it. It’s usually harmless, with quick recovery. But be alert if the faint comes without warning, happens while sitting/lying or during exertion, comes with palpitations or chest pain, or there is known heart disease — then it should be assessed.
After a faint one is clear again within seconds. After an epileptic seizure a slowing remains for minutes to hours, along with a bite on the side of the tongue, aching muscles and sometimes wet clothing. A few twitches occur in both.
A loss of consciousness without warning, sitting or lying, during sport, or with sudden cardiac death in the family is something else than a circulatory collapse from long standing. It belongs assessed quickly, with a recording of the heartbeat.
At the first signs, lie down and raise the legs — this brings blood back to the head.
Enough fluid and standing up slowly prevent the circulatory faint.
Long standing in heat, overheating and an empty stomach are typical triggers.
Fainting without warning, on exertion or with heart symptoms should be examined.
Sit up in bed first, stay sitting for 30 seconds, tense the calves a few times, then stand. If things go black, sit or lie down at once and raise the legs.
A large glass of water right after waking, drink enough across the day, salt food normally; if prone to going black, cross the legs and tense the muscles.
About four in ten people have one brief loss of consciousness in their life. In the great majority it is the harmless circulatory reflex: warning signs — greying vision, nausea, sweating — over ten to thirty seconds, then the fall, and back within a minute. With no warning at all, while lying down, under exertion, or preceded by palpitations, it counts as a heart matter and is worked up differently.
For the harmless circulatory reflex there is no drug that prevents it — beta blockers did not work in studies. What works are counter-manoeuvres in the ten to thirty seconds of warning: crossing the legs and tensing the muscles, hooking the hands together and pulling, lying down. Plus salt and fluid. What is not done also matters: someone who faints should stay flat — sitting them up lengthens the unconsciousness.
Nausea, sweating and dimming vision before it point to the harmless faint.
Dizziness/faint on standing fast often comes from a blood-pressure drop.
Sudden, while seated/lying or on exertion → get it assessed (heart).
This combination or known heart disease should be assessed.
Makes sure the muscle lets go again after tensing. A lack favours cramps, twitching and inner restlessness — and the blood value reflects the store poorly.
Where blood is lost regularly the store empties long before the haemoglobin falls. Ferritin shows this earlier than the blood count — and refilling takes months, not weeks.
Sets the excitability of muscle and nerve. A low value causes weakness and cramps, a high one is dangerous for the heart rhythm — here one measures rather than guesses.
Clearly improves the uptake of plant iron. A glass of orange juice or some pepper with the iron-rich meal does more than the choice of preparation.
Sets off the tensing in the muscle in the first place. A low value causes tingling around the mouth and in the fingers and cramping of the hands.
With circulatory collapse on standing, more salt and more fluid is the measure with data — 6–9 g of salt a day and 2–3 litres, if heart and kidneys allow it. With high blood pressure that is exactly the wrong route.
Anaemia lowers the threshold at which vision goes black. Ferritin and haemoglobin are among the first values when it has happened more than once.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
In the most common form a surge comes first — pale, queasy, sweating, ringing ears — and then the regulation flips: pulse and blood pressure fall together. Anyone who knows these warning signs can lie down before it happens.
This hormone holds salt, and with it water, in the circulation. If it is missing or there is too little salt, pressure sags on standing — which is why more salt and more fluid is the measure that works in this form.
A low blood sugar looks similar: trembling, sweating, confusion. It concerns almost only people on insulin or certain diabetes tablets — in everyone else it is a rare explanation.
The most common faint is the harmless circulatory one — and its most common cause is too little fluid. 2–2.5 litres a day and not eating too low in salt remove a large share.
Especially in older age blood pressure drops after large carbohydrate-rich meals. Several small meals and not standing up right after eating often solve it.
The most common faint is the harmless circulatory one, and its most common cause is too little fluid. 2–2.5 litres a day and not eating too low in salt remove a large share.