Loss of consciousness: causes, first aid, symptoms of disease, treatment

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Heat, stress are not uncommon causes of loss of consciousness. But even more often this symptom speaks of much more serious problems, for example, with the heart. So, let's find out the difference between fainting and losing consciousness, about the signs and causes in a person and the necessary actions with this symptom.

What is loss of consciousness

Loss of consciousness is an abnormal condition with a short-term disorder of the functions of the nervous activity and cerebral disorders that occurs with acute oxygen deficiency in the brain tissues due to blood flow disturbances. Often accompanied by inhibition of all reflexes. At this point the patient falls, does not move( excluding muscle twitching, epileptic seizure), reflexively does not react to irritating factors( tweaks, claps, heat, cold, pain, screams).

• The loss of consciousness, which lasts from a few seconds to half an hour, having varying degrees of severity, consequences and causes, is designated in medicine as syncope.
• Severe and long unconscious states distinguish as comatose.

When a patient's syncope is manifested, the patient is examined with mandatory identification of typical neurogenic, cardiological and other probable causes. About what distinguishes syncope from loss of consciousness, we will tell further.

The three most common causes of loss of consciousness will tell this video:

Difference from syncope

Two basic types of loss of consciousness are determined:

• syncope;
• is the loss of consciousness.

The difference between them is in the causes and further consequences, which are treated separately, as well as the therapy scheme. The underlying cause of syncope, as a rule, lies in the reversible disruption of the blood supply to the cerebral cells when the pressure falls suddenly.

Deep and long loss of consciousness with a prolonged lack of oxygen in the brain tissues at the base has serious organic damage, leading to a disruption of vital functions. Deepening of the condition is expressed in the growth of all signs with the development of coma.

Parameters	Syncope	Loss of consciousness
Reasons for	Neurological reactions;Orthostatic hypotension of the brain( blood supply deficiency with pronounced blood pressure drop);Morgagni-Adams-Stokes syndrome	Cardiac pathologies;stroke;epilepsy
Duration	a few seconds but not longer than 5 minutes	Longer than 5 minutes
Recovery and orientation	Fast and complete recovery of all reflex, physiological, neurological reactions	slow or not recoverable
Amnesia of near events, changes on ECG	No	Is

Next we will talk about dizziness, nausea and other symptoms of loss of consciousness.

First manifestations of

• Anxiety, a feeling of strong weakness, "cotton feet", frequent yawning, deep sighs;Paleness, sweating;
• pressing or compressive pain in the head, ringing and noise in the ears, dizziness deafness, suffocation;
• fever at the fingertips( ejection of adrenaline);
• flicker, "midges", darkening before the eyes;
• muscle spasms( tetanic convulsions);
• a strong increase in heart rate, a pressure jump;
• nausea, vomiting, sour taste in the mouth.

During fainting:

• the body is motionless, the muscles are relaxed;
• breathing - slow;
• blood pressure - low
• with deep unconsciousness, urination, convulsions;
• pupils dilated, may not respond to light in serious diseases.

About what symptom of which disease is loss of consciousness, let's talk with you further.

Disturbances and underlying diseases

The main reason for any kinds of syncope is the lack of oxygen in the brain cells, but the oxygen deficiency itself is also determined by different abnormal states.

Simple vagal syncope

Usually occurs with a spasm that causes narrowing of the feeding vessels or a rapid drop in pressure, without being associated with severe organic diseases. The most "harmless" reasons for a simple syncope:

• are stressful effects( pain and expectation, kind of blood, strong fear, nervous tension);
• reflex states: a fit of coughing, sneezing, painful urination, falling into the throat of a foreign body;obstructed defecation, intense physical stress, change of posture;
• vegetovascular disorders in panic attacks.

Consciousness after syncope of vascular genesis is completely restored. Possibility of exhaustion, panic attacks. About that, whether sudden short-term loss of consciousness can speak about problems with heart, we will tell more low.

Cardiogenic syncope

Heart disease is the primary cause of syncope of cardiogenic origin in 25% of all cases. Detection of the main pathology provoking syncopal attacks of a cardiac nature is mandatory, since without a precise diagnosis and a competent therapy scheme one can miss a serious disease with a negative prognosis.

As a rule, the factor leading to oxygen deficiency in the brain and loss of consciousness in cardiogenic disorders is a sharp decrease in the volume of blood in cardiac output( ejected into the aorta for one reduction - systole).More often it happens with a serious degree of heart rhythm disorder( arrhythmia and severe tachycardia with a frequency of more than 140 - 160 beats / min).

The typical pathologies of the rhythm accompanying cardiac fainting are attributed to Morgagni-Adams-Stokes syndrome. The loss of consciousness, caused by an unexpected decrease in the volume of cardiac output and subsequent ischemia( lack of blood supply) of cerebral cells, comes unexpectedly. Usually, such conditions rarely last longer than 2 minutes and do not provoke further pathologies in the psychoneurological area.

With acute infarction and cerebral blood flow disorder, Morgagni's syndrome is often both a cause and a consequence. Before the loss of consciousness, the patient suddenly pales and falls. One of the specific symptoms of syncope of a cardiac nature is a strong reddening of the skin.

Arrhythmic loss of consciousness

Serious pathologies that cause arrhythmic syncope:

1. Paroxysmal( paroxysmal) tachycardia is a sudden increase in the number of myocardial contractions per minute( over 150).
2. Arrhythmia of the form "pirouette"( with the revealed interval elongation Q - T) is especially dangerous for cardiac arrest. Diagnosis is complex. Often at the time of cardiogram, the state of paroxysms pass, and a false diagnosis of physiological fainting is made. And the threat of a lethal outcome remains.
3. Syndrome of weakness of the sinus node( weak central nervous system that regulates the heart rhythm).
4. Atrial fibrillation, ventricular fibrillation, in which arrhythmia develops due to chaotic contractions in the fibers of the myocardium. Reduction of each fragment occurs without communication with others, preventing the full filling of the ventricles with blood and pushing it into the aorta, followed by a deficiency in the cerebral blood supply.
5. Syndrome of ERW( WPW, Wolf-Parkinson-White), in which there is an abnormal path of impulse conduction in the myocardium. It appears in children from birth and young people from 9 to 22 years. Sidromus is dangerous for the asymptomatic hidden course, the manifestation of severe arrhythmias, the threat of cardiac arrest.
6. Atrioventricular blockade, indicating a violation of cardiac conduction, which leads to a malfunction of the rhythm of the heart muscle.
7. Extrasystoles are conditions in which the contraction of the heart( and its chambers) occurs chaotically due to structural damage and emotional stress.

In these pathologies, irregularities in the rhythm are formed, whole rows of cardiac contractions fail. The flow of blood to the brain is interrupted.

Other causes of

Other causes of small cardiac output:

• failure of right ventricular function;
• acute infarction with a sharp disruption of the ability of the heart muscle to contract properly;
• defects in cardiac structures( valve defects);
• cardiac tamponade( blocking the movements of the heart with blood filling the space between the myocardium and the heart shell);
• myxoma( benign formation in the cardiac cavity);
• aortic dissection. It is a rupture( sometimes - damage) of a large artery with blood flowing between the layers of the vessel wall. With the rupture of all layers, massive and rapid blood loss occurs.
• thrombosis of cardiac vessels. Syncope is very likely when the vessel overlaps with thrombotic masses that interfere with blood flow. Happens after operations in any area( often - with the replacement of valves, shunting), with recurrent ventricular fibrillation, acute thickening of the blood.
• atherosclerosis of the heart.

With prolonged weak functioning of coronary vessels, ischemia develops( necrosis of cells or necrosis).The active fibers of the heart atrophy, replaced by a dense connective tissue, which is unable to contract. The volume of ejection is reduced, cerebral cells are deficient in oxygen, which is expressed in syncope.

Similar cardiogenic attacks develop with:

1. Stenosis( narrowing) of the aortic aorta. Fainting with this vice means the emergence of a threat to life and the need for urgent surgery.
2. Hypertrophic obstructive cardiomyopathy - a pathological thickening of the muscle of the interventricular septum, interfering with the passage of blood.

The specialists in the video below will tell you about the diseases accompanied by syncope:

Diagnostics briefly

Data on a heart attack, existing angina, manifestations of circulatory failure, cardiomegaly( abnormal enlargement of the heart) may indicate that fainting attacks are a real threat to life.

Patients with signs of cardiac disorders and repeated loss of consciousness are examined permanently with an ECG at rest to exclude or confirm the cardiac character of syncopal seizures, to determine the probability of "sudden cardiac death".

• If a patient under the age of 40 years on the cardiogram does not show abnormal defects in the structure of the heart, then, most likely, the cause of syncope is not a small cardiac ejection. And then they consider the probability of syncope due to neurological disorders.
• In any case, with frequent relapses of syncope, diagnosed in hospital.
• Even if no signs of lesion are found on the cardiogram, in patients over 40 years of age the diagnosis begins with a complete examination of the heart.

Not all cardiac abnormalities associated with small volume in cardiac output are equally life threatening.

• Doctors note that the blockade of nerve ventricular fibers( a syndrome of incomplete blockade of the legs of the Hiss beam), often fixed on the ECG, should not lead to loss of consciousness.
• Young people often faint due to dysplasia( anomaly of the structure) of connective tissue leading to serious complications.
• A mitral valve prolapse, which is not considered a serious defect, can also cause unconsciousness during a sharp tilt, rising, especially in tall lean adolescents and young men.

Other causes of syncope

Other causes of syncope are possible:

• epileptic syndrome( often);
• steal-syndrome( vertebral-subclavian stealing);
• stroke( ischemic, hemorrhagic);
• trauma with blood loss, shock conditions( pain, hypothermia, heat stroke);
• decrease in the volume of circulating blood with diarrhea, bleeding, vomiting;
• bleeding in the stomach, intestines;
• oxygen deficiency in brain cells for asthma, thromboembolism( blockage of pulmonary artery thrombus);
• anemia with significantly reduced hemoglobin( 70-80);
• hypoglycemia( loss of consciousness occurs gradually against a background of tachycardia, cold sweat, trembling of the limbs);
• general exhaustion;
• anaphylactic allergic shock;
• toxic shock in severe infections;
• poisoning with alcohol, carbon monoxide, intoxication with poisons;
• orthostatic syncope( pressure drop with a sudden change in body position, not associated with valvular prolapse);
• sepsis;
• Addison's disease( dysfunction of the adrenal cortex);
• Sudden increase in intracranial pressure with hemorrhage, hydrocephalus, neoplasm;
• atherosclerotic deposits on the walls of the vessels of the neck, head;
• increased intrathoracic pressure in mature men( with cough, bowel movements, urination).

"Keys" for diagnosing

To make it easier to orient and help relatives, friends, colleagues with a possible fainting fit, and also to yourself, it's useful to be able to analyze the manifesting symptoms.

The most dangerous signs, manifested in the loss of consciousness:

• pain behind the sternum, shortness of breath;
• paroxysmal tachycardia( above 160 cuts per minute);
• abundant sticky and cold sweat;
• bradycardia - slow heart rate( less than 45 beats per minute);
• reduced pressure, which is maintained in the supine position;

It is necessary to know:

1. Loss of consciousness during physical exertion( and after) is considered dangerous for people of any age. This is a clear symptom of cardiogenic syncope in severe pathologies.
2. The older an unconscious person, the higher the likelihood of a serious cause of syncope, including the pathology of the heart.
3. If the duration of "interruptions" in the heart before fainting exceeds 5 seconds, these irregularities signal serious heart diseases.
4. Involuntary muscle twitching and short convulsive attacks develop not only with an epileptic attack, but also with temporary cerebral ischemia, which is caused by heart disease.
5. The loss of consciousness of any duration with the patient's cardiac pathologies is considered a serious symptom.

On what to do after losing consciousness, what is the first help with this, read below.

Loss of consciousness activities

Primary care provided with syncope can save many if the cause is a serious disorder in the body.

In any cases it is required:

• to check if there are injuries and bleeding;
• to check heartbeat on the carotid artery, pupils to light reaction.

In the absence of pulse and respiration, immediately begin artificial ventilation and cardiac massage until an ambulance arrives( after 4 to 6 minutes, brain cells deprived of oxygen die irretrievably).

1. to unbutton clothing on the chest, straps or any objects compressing the chest and stomach;
2. ensure the supply of fresh air;
3. remove from the mouth vomit and do not allow the tongue to sink into the throat;
4. put the person on the right side with an emphasis on the left knee( left hand under the head).This position will prevent suffocation from vomiting and the tongue overlapping the airways.
5. apply the old effective method with simple fainting - ammonia on the cotton wool under the nose.

The first help in fainting will tell Elena Malysheva in this video: