Vaso - Vagal Syncope
The exact mechanism of syncope is still under study. In this condition, there appears to be a transitory fall in blood pressure due to the failure of peripheral resistance. This momentary fall in blood pressure causes a decreased flow of blood to the brain, prominent to syncope, during which time there is a transient/brief form of unconsciousness, and the outpatient may fall to the ground, if he remains standing, i.e., does not sit, or lie immediately. Before his fall, he may feel some symptoms like nausea, giddiness, vertigo, disturbance of vision/hearing, confusion of foresight or odd noises in the ears, body pallor, rapid respiration and sweating, etc.
If the assault is a prolonged one, in some of the cases, even twitching/jerky movements, or open convulsions may occur, thus creating some strangeness in diagnosing the health clinically. Such attacks occur normally only in a standing/upright position. They do not occur when the outpatient is whether lying down or sitting. The outpatient is not confused after the attack, although he still may be undergoing feelings of nausea.
This problem appears particularly in normal young adults, especially in females, with no inescapable pathology which could catalogue for these attacks. Such cases are normally seen in day-to-day practice, and can be embarrassing adequate to cause anxiety.
The attacks are normally precipitated when a man keeps standing for a long time, e.g., as is sometimes seen in school students when they fetch for their morning prayers (childhood syncope), or in older students standing for hours in assorted laboratories, and similarly in policemen and soldiers, when they happen to stand on duty at one place for a indispensable distance of time.
Also, the attacks are aggravated when a man suddenly stands up after lying down or sitting for a long period, or when the man gets up suddenly during his sleep at midnight/morning. Further, bad news or sight of blood, i.e., emotional shock, intense fear/pain, hot weather or a stuffy atmosphere, hunger, intake of immoderate alcohol or loss of fluids, i.e., dehydration etc., may also begin these attacks.
Recovery in vaso - vagal syncope occurs after the man lies down. There is no basal cause. There is only a failure of peripheral resistance which causes the assorted conditions mentioned above.
Cardiac syncope
Cardiac syncope, i.e., syncope as a effect of some basal heart disease, occurs suddenly, without any warning symptoms. In such cases, there is a sudden fall in cardiac output/blood pressure, as a effect of assorted diseases of the heart, like arrhythmias, such as when the heart rate is very high (paroxysmal atrial tachycardia-Pat, atrial fibrillation), or in a heart block (Stokes-Adams attack) when the heart rate becomes extremely slow, or in advanced cases of aortic stenosis (aortic valve disease), which effect in a decreased flow of blood to the brain, etc. Hence detailed tests like electrocardiogram Ecg (with a long rhythm strip), Holter monitoring (to detect arrhythmias), echocardiography (to detect aortic / other valvular diseases), etc., are required, besides an Eeg, in some cases, for definite pathology and treatment.
