Also known as fainting, or syncope.
What is it? it refers to a sudden and temporary loss of consciousness, usually due to the lack of oxygen in the brain. Oxygen deprivation in the brain has many possible causes, including hypotension or low blood pressure.
Often, an episode of lipothymia has no medical significance, but sometimes it is the result of a serious illness, condition or disorder.
Each case of fainting should be treated as a medical emergency until the cause is known and the signs and symptoms have been treated.
Anyone who has recurring episodes of fainting should consult a doctor.
Causes of lipothymia
Lipothymia is usually the result of hypoxia or lack of oxygen in the brain.
Causes include problems with the lungs or blood circulation and carbon monoxide poisoning. Fainting is a mechanism to help a person survive.
If the blood in the brain and oxygen levels are significantly reduced, the brain immediately closes all other parts of the body that are not vital, so that the resources can be focused mainly on the vital organs.
When the brain detects lower levels of oxygen, the body will begin to breathe faster, or hyperventilate, to raise levels again.
The heart rate will also increase to get more oxygen in the brain. This increase in heart rate results in hypotension, or a drop in blood pressure, in other parts of the body. The brain receives extra blood at the expense of other parts of the body.
Hyperventilation combined with hypotension can cause short-term loss of consciousness, muscle weakness and fainting.
There may be different underlying causes of lipothymia:
Neurocardiogenic syncope : occurs when something triggers a short-term malfunction of the autonomic nervous system (ANS). It is also known as neurally mediated syncope (SMN).
SNA affects heart rate, digestion, respiratory rate, salivation, perspiration, pupil diameter, urination, and sexual arousal.
Most of these actions are involuntary, but some, like breathing, can also be done consciously.
There will be a drop in blood pressure and the heartbeat and pulse rate will decrease. This causes a temporary interruption in the brain’s blood and oxygen supply.
Possible triggers include:
- Seeing something that is unpleasant or shocking, like blood.
- Sudden exposure to an unpleasant experience
- Sudden emotional discomfort, for example when receiving bad news.
- Extreme shame.
- Stay stopped for a long time.
- Being in a hot and congested place for a long time.
Occupational or situational syncope is a type of neurocardiogenic syncope, but the link is more physical than emotional, mental or abstract.
Triggers may include:
- Cough or sneeze
- Laughing or swallowing
- Defend or urinate.
- Demanding physical activities, such as lifting a heavy weight.
Orthostatic hypotension can occur when a person faints after getting up quickly from a sitting or lying position.
Gravity draws blood to the legs, which lowers blood pressure elsewhere.
Normally, the nervous system of the body reacts by raising the heart rate and narrowing the blood vessels. This stabilizes blood pressure.
However, if something undermines this stabilization process, there may be little blood and oxygen supply to the brain, leading to fainting.
Dehydration: if body fluid levels fall, so will blood pressure. This can make it more difficult for the body to stabilize blood pressure, which results in less blood and oxygen reaching the brain.
Untreated diabetes : a person with diabetes can urinate more often, which leads to dehydration. High levels of glucose in the blood can cause damage to some nerves, especially those that regulate blood pressure.
Some medications : diuretics, beta-blockers, and antihypertensive medications may cause orthostatic hypotension in some people.
Alcohol : Some people faint if they consume too much alcohol in a short space of time.
Some neurological conditions : Parkinson’s disease and other conditions affect the nervous system, and this can lead to orthostatic hypotension.
Carotid sinus syndrome : Pressure on the pressure sensors in the carotid artery can cause fainting. These pressure sensors are known as the carotid sinus. The carotid artery is the main artery that supplies blood to the brain.
If the carotid sinus is too sensitive, blood pressure may decrease if it is stimulated physically, which causes fainting. Examples include turning the head to the side, wearing a tight collar or pressing on the carotid sinus while shaving.
This is more common among men older than 50 years.
Heart syncope : an underlying heart problem can cause a drop in the blood and oxygen supply to the brain.
Possible conditions include:
- Arrhythmias or abnormal heartbeat.
- Stenosis, a blockage of the heart valves.
- Hypertension or high blood pressure.
- A heart attack, when a heart muscle dies from lack of blood and oxygen.
This cause of fainting will usually need treatment and monitoring.
The sign of fainting is a sudden loss of consciousness.
The following signs and symptoms may occur before a fainting episode:
- A feeling of heaviness in the legs.
- Blurry vision.
- Feeling warm or hot
- Stunning, dizziness, floating sensation.
When a person faints, they can:
- Fall or collapse
- It appears unusually pale.
- You experience a drop in blood pressure and a weak pulse.
Types of lipotomy
In addition to distinguishing the types of fainting by their causes, there is also almost complete faintness and lipotimia.
Previous or almost faintheartedness is when the person can remember events during the loss of consciousness, such as dizziness, blurred vision, muscle weakness. They can remember falling before hitting their heads and losing consciousness.
The complete faintness is when the person can remember the feelings of dizziness and loss of vision, but not the fall.
If there is an underlying health condition, it will be necessary to treat it. The treatment will help prevent future episodes of fainting.
Often, no additional treatment is needed. To avoid further episodes, the person should avoid triggers, such as long periods of immobilization, dehydration, and being in hot, congested places.
If the sight or thought of injections or blood makes a person feel faint, they should notify their doctor or nurse in advance.
The health professional can make sure the patient is in a safe position, such as going to bed, before any procedure begins.
Beta blockers are mainly used to treat high blood pressure, but they can help if the neurocardiogenic lipotimia interferes with the quality of life of a person.
Adverse effects of beta-blockers include fatigue, cold hands and feet, slow heartbeat and pulse, nausea, and diarrhea.
What to do in case of fainting
If you feel weak:
- Find a place to sit or lie down.
- When you are sitting, place your head between your knees.
- When you get up, do it slowly.
If you see someone faint:
- Place the patient on his back, face up.
- If you are breathing, lift your legs about 12 inches above the level of the heart to restore blood flow to the brain.
- Try loosening all belts, ties, collars and restrictive clothing.
- When the person gets up, do not let them get up too quickly.
- If they remain unconscious for more than a minute, place them in the recovery position and get emergency medical help.
If the person is not breathing:
- Check for breathing, coughing or movement.
- Make sure the airway is clear.
- If there are no signs of breathing and circulation, start cardiopulmonary resuscitation (CPR).
- Continue CPR until help arrives or the patient begins to breathe on their own.
- Put them in the recovery position and stay with them until help arrives.
- If the individual was injured and is bleeding after the fall, apply direct pressure to control the bleeding.
Sometimes, what looks like a simple episode of fainting can be something more serious, like a stroke.
If the person experiences numbness in the face, paralysis, weakness, numbness in one arm or difficulty speaking, they need emergency medical help.
People should see their doctor if:
- They had pains in the chest or irregular or strong heartbeats before losing consciousness.
- They have a history of heart disease.
- The fainting resulted in an injury.
- The fainting was preceded by fecal or urinary incontinence.
- Pregnant woman.
- They experience recurring episodes of fainting.
- If they have diabetes.
- They were unconscious for more than a few minutes.
The doctor will need to know about:
- The medical history of the person and any medication taken.
- If this was an isolated case, and if not, details of previous episodes.
- Family history, for example, if a close relative has heart disease.
- What the person was doing, where they were and what happened just before the fainting occurred.
- Any other symptoms
The doctor will listen to the patient’s heart to assess the underlying cardiac conditions. If the signs and symptoms suggest a heart problem, the person may need to see a cardiologist.
Tests may include:
- An electrocardiogram (ECG) to check the electrical activity of the heart.
- Carotid sinus stimulation, to determine if this triggers stun symptoms or dizziness.
- Blood tests to detect anemia, diabetes or an infection.
- Tilt test of the table, to control blood pressure, heart rate and heart rate while the person moves from a lying position to an upright position.
- A Holter monitor test, where the patient uses a portable device for which records all the beats of his heart.
The monitor is worn under clothing. Record information about the electrical activity of the heart while the person carries out their normal activities for 1 to 2 days.
The device has a button that can be pressed if specific symptoms are felt. The records will show which heart rhythms were present at that time.
If none of these tests reveal anything unusual, the doctor will probably conclude that the patient had neurocardiogenic syncope. No treatment will be needed.