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Fainting (syncope)

Syncope · Mdloba (synkopa)

What it is

A brief loss of consciousness from a fall in blood flow to the brain, with quick full recovery; most is reflex (vasovagal) and harmless, but fainting on exertion or with palpitations may mean heart disease.

Symptoms & signs

  • Light-headed, warm, sweaty, pale beforehand
  • tunnel vision
  • brief loss of consciousness, sometimes a few jerks
  • quick recovery
  • tiredness afterwards

🚩 Get help if…

  • call 112 / 911 now Fainting during exercise or while lying down
  • call 112 / 911 now Fainting with chest pain, a racing or pounding heart, or breathlessness
  • call 112 / 911 now Not waking fully within a minute, or new weakness or slurred speech
  • see a doctor soon Sudden death under 40 in the family, or several faints in a short time

Where it strikes

Medical treatment

  • History, ECG, blood pressure lying and standing
  • heart tests for high-risk faints (on exertion, family sudden death, abnormal ECG)
  • implantable loop recorder for recurrent unexplained faints
  • pacemaker for faints with long pauses
  • Midodrine or fludrocortisone for recurrent reflex syncope mixed evidence
  • stop culprit blood-pressure drugs

Natural & lifestyle

  • Counter-pressure manoeuvres (crossing legs, gripping hands) at the first warning trials support
  • more fluid and salt
  • lie down with legs raised

Emerging & experimental

  • Cardioneuroablation for severe vasovagal syncope
  • closed-loop pacing

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Tilt training — trials disagree mixed evidence
  • Compression stockings — used for pooling in the legs; little evidence anecdotal / traditional
  • Smelling salts — traditional; no evidence anecdotal / traditional

ICD codes