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Syncope ((syncope ⓘ), commonly known as fainting or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. [1] It is caused by a decrease in blood flow to the brain , typically from low blood pressure . [ 1 ]
The San Francisco Syncope Rule (SFSR) is a rule for evaluating the risk of adverse outcomes in patients presenting with fainting or syncope. The mnemonic for features of the rule is CHESS: • C - History of congestive heart failure • H - Hematocrit < 30% • E - Abnormal ECG • S - Shortness of breath • S - Triage systolic blood pressure < 90
Reflex syncope can occur in otherwise healthy individuals, and has many possible causes, often trivial ones such as prolonged standing with the legs locked. [citation needed] The main danger of vasovagal syncope (or dizzy spells from vertigo) is the risk of injury by falling while unconscious.
Tilt table testing could provoke fainting or syncope. It is the purpose of the test to provoke these symptoms, in order to aid in diagnosis. [ 4 ] It may not be appropriate, or indeed even possible, to stop the test before fainting occurs, as the drop in blood pressure or pulse rate associated with fainting can come on in seconds.
[2] [3] [4] Used to identify orthostatic hypotension, [5] orthostatic vital signs are commonly taken in triage medicine when a patient presents with vomiting, diarrhea or abdominal pain; with fever; with bleeding; or with syncope, dizziness or weakness. [2]
Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
Micturition syncope or post-micturition syncope is the name given to the human phenomenon of fainting shortly after or during urination. The underlying cause is not fully understood, but it may be a result of vasovagal response , postural hypotension , or a combination thereof.
Apart from treating underlying reversible causes (e.g., stopping or reducing certain medications, treating autoimmune causes), several measures can improve the symptoms of orthostatic hypotension and prevent episodes of syncope (fainting). Even small increases in the blood pressure may be sufficient to maintain blood flow to the brain on standing.