Fainting (Syncope)

Although the term SENKOP is translated into Turkish as “FAILING”, its meaning in the literature is actually slightly different. It is roughly a type of “fainting” or “temporary loss of consciousness”.

When we say “fainting”, any temporary loss of consciousness can be understood.

However, SYNCOP; “sudden-rapid onset, short-term, self-healing, temporary loss of consciousness due to temporary decrease in cerebral blood flow”is defined as.

According to this definition, while epileptic seizures, psychological fainting (conversion, hysteria), loss of consciousness due to hypoglycemia (low blood sugar) can be called “fainting”, they cannot be called “syncope” because their mechanism is not “decreased cerebral blood flow”.


In this case, other conditions that can be confused with the causes of syncope should be distinguished by the physician. Other conditions that can be confused with syncope:

  • Conditions of Partial or Complete Loss of Consciousness Without Decreased Cerebral Blood Flow


metabolic disorders

Hypoglycemia (low blood sugar)

Hyperventilation (Changes in blood as a result of rapid and deep breathing)

Hypoxia (decreased amount of oxygen in the blood)


Transient ischemic attack of vertebrobasilar origin

  • Conditions Without Impairment of Consciousness

Psychological faints (Pseudosyncope=Pseudo syncope)

Falls, fall attacks

Catalepsy (temporary loss of muscle strength, mostly in schizophrenia)

Transient ischemic attack originating from the carotid (neck vein)

Just as we mentioned when describing the “palpitation”, there is often no evidence in a syncope attack that has happened and we don’t know when it will happen again. So to speak, there is an unsolved situation, and we are detectives trying to reach the perpetrator by making our inquiries based on clues. The story of syncope is as valuable to us as the place, time, before and after the event, and the moment of the event are for a detective.

In syncope, the patient cannot know his condition after he loses consciousness, so the observations and stories of those who are with him at that moment are at least as valuable as what the patient tells. For this reason, it is important for those who will come to us with the complaint of syncope to bring witnesses, if any, or to tell us exactly what the witnesses have told us.

Let’s write down the questions we asked to evaluate the cause of syncope here, so that those who come to us with this complaint will come prepared. 🙂

1.) Questioning Before His Attack

Position ?;

While standing, sitting or lying on your back…

Activity ?;

What exactly were you doing when syncope occurred? At rest, during body position change, before or after exercise, urination, defecation, coughing…

Preparatory or Triggering Factors ?

Crowded and hot places, closed and narrow environment, stress, prolonged standing, after dinner, fear, stress, head movements…

Situations seen at the beginning of the attack?

Nausea, vomiting, abdominal pain, rumbling, feeling cold, sweating, pain in the neck and shoulders, blurred vision, dizziness, palpitations…

2.) Questioning of Syncope Attack

way of falling

Skin color (pale, cyanotic, redness),

duration of unconsciousness,

breathing pattern,

Movements and duration of movements

biting tongue,

urinary incontinence,

Mouth foaming, shape of eyes

Blood pressure and pulse, if measured

attack frequency,


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3.) Questioning the Patient’s History

Family history of sudden death, congenital arrhythmogenic heart disease, or fainting

past heart disease

Neurological history (Parkinson, epilepsy, narcolepsy)

Metabolic disorders (diabetes, thyroid diseases, etc.)

Medications (antihypertensive, antianginal, antidepressant, antiarrhythmic, diuretic)

and habits such as alcohol-smoking-substance use.

After the initial evaluation by asking these questions, strong ideas can be obtained about what syncope is due to. However, examinations and evaluation of different branches are often needed.

Cardiology, neurology or sometimes psychiatry departments evaluate the patient who is admitted to the hospital with fainting-temporary loss of consciousness. After the first evaluation, it is distinguished whether the loss of consciousness is a true syncope, the most probable causes are revealed, and tests are performed to confirm the diagnosis or exclude it.

In the evaluation of syncope; ECG, Echocardiography, Exercise test, Rhythm Holter, short or long-term event recorders (Event Recorder), Tilt-Table test, Electrophysiological Study (EFS) and some neurological tests (EEG, brain tomography or MRI) ) may be needed

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