Sinkope

Sinkope, commonly known as fainting, is a temporary loss of consciousness and postural tone characterized by rapid onset, short duration, and spontaneous recovery. It typically results from a sudden reduction in blood flow to the brain, often due to decreased cardiac output or cerebral perfusion. While generally harmless, episodes of sinkope can be distressing and may indicate an underlying medical condition requiring evaluation.

The most common cause of sinkope is vasovagal syncope, triggered by emotional stress, pain, or prolonged standing. This type of fainting occurs when the body’s autonomic nervous system overreacts, causing a drop in heart rate and blood pressure. Other potential causes include cardiac issues such as arrhythmias, structural heart disease, or severe anemia, as well as neurological, metabolic, or respiratory conditions. Situational factors, like coughing, swallowing, or micturition (voiding), can also provoke episodes in susceptible individuals.

Symptoms preceding a syncopal event often include lightheadedness, nausea, sweating, blurred vision, and palpitations. Some people experience an aura or warning sensation before losing consciousness. Recovery is usually rapid, with patients regaining full alertness within minutes. However, falls during an episode may result in injuries, particularly in older adults.

Diagnosis involves a thorough medical history, physical examination, and sometimes electrocardiogram (ECG), Holter monitor, or tilt-table testing to identify the underlying cause. Treatment depends on the underlying etiology, ranging from lifestyle modifications (such as increasing salt and fluid intake) to medications (e.g., beta-blockers) or, in severe cases, implanted devices like pacemakers or defibrillators. Patients with recurrent or unexplained syncopal episodes should seek medical evaluation to rule out serious conditions.