more about SYNOCOPE …

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Syncope implies a sudden and usually transitory and reversible loss of consciousness which may occurs under a variety of conditions ranging from simple vasovagal faintto most serious form of cardiac disease. Basically it results from a sudden reduction in cerebral blood flow due to a fall in cardiac output.
The most common type of syncope is vasovagal attack which is often precipitated by sudden intense emotional upset. This triggers vigorous autonomic discharge producing intense vagal stimulation and depression of vasomotor centre. Consequently, there occurs bradycardia, pallor, sweating and fall in blood pressure due to sudden vasodilatation in muscles and in splanchnic bed, through skin vessels are constricted. The patient who is often in upright posture may experience warning symptoms such as nausea, sinking sensation, dizziness, blurring of vision and even vomiting. If the patient mamages to sit or lie down, further progress of symptoms may cease, otherwise unconsciousness follow and even convulsions may occur. Yhe onset of unconsciousness immediately restores automatic balance, and this coupled with the recumbent posture, establishes adequate cerebral blood flow. A quick recovery therefore occurs, without any associated mental confusion or abnormal neurological signs.
The precise treatment in a given case will obviously vary according to the case of synocope which should be established as quick as possible. Invariably, a vasovagal attack would be over by the time medical aid arrives. Subjects who are prone to these attacks should be advised to avoid quiet standing in crowds for prolonged periods especially in hot weather and stuffy environments as this results in peripheral pooling of blood, sweating and hypovolaemia. Any patient who threatens to faint should be promptly laid flat, clothes around the neck loosened and the tongue prevented from falling back. In carotid sinus synocope, ephedrine 15mg three times a day may be effective, while in cases with postural hypotension, attack may prevented by sympathomimetic drugs, use of abdominal binders, elastic crepe bandages below the knees, use of excessive common salt or periodic injections of DOCA.


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