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The legs give out. The view becomes blurred. You lose consciousness. And he passes out. Syncope, with loss of consciousness, is a fairly frequent occurrence, so much so that every year about six million people encounter phenomena of this type. But you need to know the picture to better address it, especially for women.
This is why a campaign is launched that will go on on the web in April, specifically aimed at women. It was commissioned by the Onda Foundation, the National Observatory on Women’s and Gender Health, and is called “Syncope: let’s learn to recognize it”. The initiative is sponsored by GIMSI, the multidisciplinary group for the Studio della Sincope chaired by Andrea Ungar.
Sometimes it is enough to change position
Technically, fainting is linked to a temporary loss of consciousness, which is not common only in those suffering from cardiovascular diseases but can also occur in perfectly healthy people. Suffice it to say that the most frequent cause of syncope is related to defined as a vaso-vagal reaction: the brain goes into “black-out” for a few seconds because it is not properly supplied by the bloodstream as a result of a rapid reduction in blood pressure and heart rate.
The other, rarer forms of syncope can be linked to two types of reasons: cardiac causes is orthostatic hypotension. The former are the most dangerous and it is necessary to recognize them in time to implement the appropriate countermeasures, while those linked to orthostatic hypotension, perhaps because you get out of bed quickly, are linked to a drop in blood pressure when the patient stands up and are more frequent in the elderly, when obviously the “control” systems are no longer perfectly efficient.
In most cases, it is possible to prevent vaso-vagal syncope by knowing the warning symptoms such as sweating, “abdominal discomfort”, light-headedness, transient loss of consciousness during emotional stress, preceded or followed by nausea or vomiting.
Very different they are the warning symptoms of cardiac syncopes: palpitations, breathlessness and chest pain may be present. In general, when syncope is not associated with heart disease, it has a benign prognosis. In the heart patient, however, syncope can represent the premonitory symptom of a fatal event. It is therefore important not to underestimate the clinical significance of this symptom and to seek medical attention.
How to deal with “ad hoc” centers
Obviously the picture must be defined by the doctor. But it must be said that there are specialized structures, which need to be known, defined with the English term of Syncope Unit.
In Italy there are 69 hospitals with Syncope Unit, a functional structure whose task is to provide a standardized approach for the diagnosis and management of transient loss of consciousness and related symptoms, with a dedicated staff and with the possibility of accessing the diagnostics according to a facilitated path and to provide the correct therapeutic indications. The Syncope Unit can be part of the Emergency Department and the team includes cardiologists, geriatricians, internal medicine doctors and neurologists.
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