Syncope is transient loss of consciousness due to global cerebral hypoperfusion.
In other words, it's when the brain switches off suddenly to protect itself.
The way I can explain it best is when you have a power surge, the computer
goes into safe mode and then when the danger is over, you can switch back normally.
That's exactly what the brain does.
The brain is the boss, and when there's sudden drop in blood pressure, the brain in order to protect it,
within milliseconds, it switches off.
When the danger is over, it switches back on again and that is syncope.
The most common cause of syncope is autonomic dysfunction.
So we have our autonomic nervous system, which we take for granted which is automatic.
Let's say, if we ran for the bus, our heart rate would go up, our blood pressure would also go up.
In certain conditions, this can suddenly misfire and malfunction.
That often causes syncope and often it occurs in two extremes of age:
either the very young or the very elderly.
It can be also due to simple things. Be due to simple things like dehydration.
So if you think about your body as a column of water, you've got your head at the top and your leg at the bottom.
If you're dehydrated that column of water can drop and you feel dizzy first and then you can have syncope.
There are other causes like medication, for instance, nitrates or if you're having a nitrous due to angina,
or if you're standing in a long queue for a prolonged period of time,
or if you have stress or if you have other factors such as multiple drugs, you can have syncope.
It's best to get it checked out by an expert.
Syncope can often be harmless like a simple faint,
but when it's a complex syncope, it can be dangerous.
You can suddenly have arrhythmias which can stop the heart.
You can go into asystole or flatline and that can indeed be a life-threatening condition
or you can have autonomic problems where you could suddenly have an autonomic dysfunction
when you're driving or crossing the road and it can be very dangerous.
So what we normally do is we do a tilt table test and we stratify your risk
into low-risk, intermediate risk and high risk.
So obviously if you are high risk, we give you treatment which are tablets usually.
If you're intermediate risk, then it is because a provocation, so we give a pill in the pocket
and then if it is low risk, we look at the risk factor and often people can lead a normal life.
So although it can be dangerous, it is perfectly treatable.
So we can prevent syncope by simple measures.
We always ask people to drink more water, which is often not done,
so I tell my patients that as soon as you get up in the morning,
you need to take two glasses of water and drink 2 to 3 litres every day litres.
And we have got wonderful tablets like Midodrine and Fludrocortisone.
So those are very good for vasal depressor syncope.
If you have cardioinhibitory syncope, then often you may need a pacemaker but that's often not the case.
I think we can treat it with lifestyle prevention, by following simple instructions and medication.
So the treatment is very satisfactory. People can return back to a normal life in most cases.