How is sudden syncope caused? What do you eat when you suddenly faint? Sudden syncope

Zhang Shaowu, attending physician of Huafeng Hospital in Guiyang: Pay attention to exclude sick sinus syndrome and seizures. After syncope, CCTV Road to Health (July 29th, 2002) cutie is a professor of cardiology in Fuwai Cardiovascular Hospital of China Academy of Medical Sciences, and the director of clinical electrophysiology research room. He has profound attainments in the diagnosis and treatment of arrhythmia. Professor, Hua Wei, deputy director of the Department of Cardiology, Fuwai Cardiovascular Hospital, China Academy of Medical Sciences, is good at the diagnosis and treatment of arrhythmia and has rich experience in the application of implantable cardioverter defibrillator with pacemaker. Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about syncope. Moderator: What is the definition of syncope? Cutie: Syncope is defined as sudden and temporary loss of consciousness accompanied by syncope, which is the most serious symptom of the nervous system. Moderator: What causes syncope? Hua Wei: Syncope can be divided into cardiogenic syncope and non-cardiogenic syncope. Cardiogenic syncope is syncope caused by cardiovascular disease, which has serious consequences and even leads to death. Non-cardiogenic syncope includes vasovagal syncope and neurological diseases. This kind of syncope is common in clinic, but its severity is far less than cardiogenic syncope. Cutie: Generally speaking, patients with heart disease may have syncope, but it doesn't mean that patients with heart disease will definitely have syncope. Heart disease that can show syncope includes two situations: 1 and severe arrhythmia. 2. Obstructed cardiac blood output, including obstructive cardiomyopathy and severe aortic stenosis. Warwick: Let's watch a movie. A normal heartbeat is very regular. Too fast or too slow heartbeat will lead to insufficient cardiac output, which will lead to cerebral ischemia and syncope. Moderator: Are syncope manifestations caused by various reasons the same? Cutie: Syncope is a clinical symptom. No matter what the heart condition is, as long as the effective cardiac output suddenly decreases, syncope will occur. Clinically, many patients with syncope will fall or even have incontinence. Moderator: If you usually encounter a patient with syncope, how should you rescue him? Warwick: First aid should be given as soon as possible. Cardiopulmonary resuscitation should be carried out under the existing conditions, including manual compression and mouth-to-mouth resuscitation, to gain time and wait for the arrival of an ambulance. Let's watch a movie. The first step is to lay the patient's body flat in a proper position. The second step is to help the patient raise his head and keep the respiratory tract open. Step three, unbutton your clothes and beat your chest. The fourth step is to press the chest and do artificial respiration. Cutie: Not all syncope should be rescued by the above first aid methods. Non-cardiogenic syncope can recover by itself, and sudden death can occur if cardiogenic syncope is not given first aid. After a patient faints, the type of syncope should be judged first. The easiest way is to feel the pulse and listen to the heartbeat. If not, cardiopulmonary resuscitation is needed. Compere: Is there any way to prevent syncope? Cutie: It can be prevented. First of all, we should find the cause of syncope, and then take corresponding preventive measures according to the mechanism of syncope. For example, when the heart stops beating during syncope, it is necessary to stop beating, such as using a pacemaker. If the heart is blocked during syncope, surgery should be performed to remove the blockage. Moderator: Ms. Tian, Shandong, my father's heart rate is usually slow. One day, when he was walking after dinner, he suddenly fainted and twitched all over. A few minutes later, he woke up again. What happened? Do you need treatment? Warwick: The patient fainted due to cerebral ischemia caused by prolonged cardiac arrest. The most effective treatment for this condition is to use a pacemaker. Look at these two pictures. Pacemakers can help the heart beat and maintain sinus rhythm. The pacemaker is buried in the chest pocket and the lead is placed at the heart. Patients need to wear pacemakers for life. Pacemakers have a life of about 8 years and need to be replaced regularly. Moderator: Mr. Zhou from Tianjin, my wife had a myocardial infarction last year. She suddenly fainted a month ago and woke up a few minutes later. The same thing happened again the other day. Now the family is very nervous. What should I do? Cutie: This is a patient with coronary heart disease. In the case of acute coronary artery ischemia, it will lead to serious arrhythmia, and syncope will occur in a short time due to the restriction of cardiac blood output. This kind of syncope is very serious, and it can even lead to sudden death if it is not handled properly. Once it is confirmed that the patient is syncope for this reason, he can be treated with a defibrillator. As shown in the picture, this defibrillator is about the size of a matchbox and can be buried in the body. When the patient has ventricular tachycardia or ventricular fibrillation, the defibrillator can automatically identify and discharge, and timely defibrillation can save the patient's life. Moderator: Ms. Hu from Shantou. My mother suffers from congenital heart disease. Sometimes my heart beats very fast, and I can jump to 125 at the earliest. She fainted once because of emotion. Can I take some medicine to treat it? Hua Wei: Patients need to take nitroglycerin and other drugs because of acute myocardial ischemia, and it is very likely that patients will have ventricular tachycardia or ventricular fibrillation. In addition to taking drugs to improve myocardial ischemia, it is more important to bury defibrillators to prevent sudden death, because there is no guarantee that syncope will occur in the future, which is often fatal. Moderator: Mr. Shi, from Fujian, my grandfather has suffered from heart disease 10 for many years. He has fainted twice, and then he has been carrying nitroglycerin and quick-acting pills. If he fainted, which of these two drugs should he take? Cutie: Once you pass out, neither of these drugs will have any effect. Both drugs supply blood to coronary artery, which can help coronary artery dilate and relieve heart ischemia. After syncope, because the heartbeat may be fast or slow, we should take corresponding measures for the heartbeat. Moderator: Mr. Zhang, a native of Shanxi, whose father fainted due to myocardial infarction last year. He went to the hospital for emergency treatment and was electrocuted. Later, I had a stent and fainted after leaving the hospital. How did this happen? What should I do? Hua Wei: Electrical defibrillation is a treatment for ventricular fibrillation. Patients can improve myocardial ischemia with stents. However, after myocardial infarction forms scar, the mechanism of arrhythmia still exists and syncope may occur. In this case, the most effective solution is to put in a defibrillator. Moderator: Mr. Xu from Xinjiang, 46 years old. I often fainted at school. It happens once or twice a year now. My blood pressure is normal. What is the reason? What should I do? Cutie: The patient's condition is complicated. First of all, it is necessary to judge whether syncope is cardiogenic or non-cardiogenic. There are two kinds of syncope in patients: 1 and angioneurotic syncope. 2, hypertrophic cardiomyopathy, under the conditions of exercise and tension. , aggravating blood discharge obstruction, causing syncope. It is suggested that patients find out the causes under the guidance of cardiovascular doctors and then treat them symptomatically. Moderator: Mr. Wang from Xinjiang. My brother suddenly fainted after coughing. What is the reason? Hua Wei: If the patient has cardiogenic syncope, there is no necessary connection between cough and syncope. First of all, we should check the structure of the heart, such as obstructive cardiomyopathy and valve stenosis. If syncope is not caused by the heart, we should consider whether it is caused by epilepsy, carotid sinus allergy and other reasons. Moderator: Mr. Guan Kunming, 56 years old. I have myocardial ischemia and hypertension. I had a pituitary adenoma resection for 4 years. After the operation, I suddenly fainted twice. I have no feeling or consciousness. How can I prevent this? What should I do if I have another attack? Cutie: Pituitary tumor surgery may lead to syncope due to hormonal regulation, and brain surgery may also be the cause of syncope. What is the specific reason? You should go to the hospital for a comprehensive examination. Moderator: Ms. Inner Mongolia Zong, my husband often faints and is stiff all over. He went to the hospital because of atrial fibrillation. What should I do when I faint? Hua Wei: Some patients have a rapid heartbeat during atrial fibrillation, but sometimes it is normal. When atrial fibrillation suddenly turns to normal heartbeat, it will cause cardiac arrest. If the cardiac arrest lasts too long, it may cause syncope. In addition, atrial fibrillation is easy to cause heart thrombosis, and cerebral embolism caused by thrombus shedding can also cause transient syncope. If the patient has repeated syncope without hemiplegia, it may be cardiogenic syncope, and symptomatic treatment will be given after diagnosis. Moderator: Ms. Feng, Sichuan, 5 1 year old. I have suffered from heart disease for many years, and I often faint. I have diabetes and hypertension. How should I treat it? Cutie: Patients are more likely to have cardiogenic syncope, which may be related to arrhythmia. It is recommended to carry out 24-hour electrocardiogram, echocardiography and other related examinations. In addition, when diabetes develops to a more serious degree, it may also produce syncope, which is a peripheral nervous system disease caused by diabetes, and patients will produce a postural hypotension. Moderator: Ms. Xie from Tianjin, my grandmother had a cerebral hemorrhage due to high blood pressure a year ago, and her heart was not very good. Not long ago, she fainted. The doctor said it was caused by the heart, and both diseases could faint. How to distinguish and what preventive measures should be taken? Hua Wei: First of all, check whether there is coronary heart disease. If the patient suffers from coronary heart disease, he may faint due to arrhythmia. Cerebral embolism caused by hypertension itself may lead to cerebral ischemia and syncope. Patients should first judge what causes syncope through examination, and both reasons should be paid attention to. Moderator: Ms. Cai from Jiangxi, 45 years old. My husband's arrhythmia, fast and slow, has passed out several times. How should I treat him? Cutie: There is a clinical disease called bradycardia syndrome. The most common condition is cardiac arrest with atrial tachycardia. Pacemakers can be used to solve the problem of slow heartbeat and drugs can be used to solve the problem of fast heartbeat. Moderator: My husband has an acute myocardial infarction, and now he has arrhythmia and transient shock. Is it dangerous? How to treat it? Hua Wei: The possibility of syncope caused by myocardial infarction is very high. If not actively treated, it will be very dangerous to faint again, and some patients will die suddenly. In addition to actively treating the primary disease, patients should also be equipped with defibrillators if possible to prevent sudden death in the future. Moderator: Ms. Zhang, my mother in Sichuan suffers from rheumatic heart disease and arrhythmia. She fainted twice. Is there any danger of sudden death? What should I do? Cutie: The patient is in danger of sudden death. Rheumatic heart disease is a valve disease. If the aortic valve is severely narrowed, syncope will also occur. Patients should be further examined and treated. Moderator: Mr. Feng from Beijing, 45 years old. My sister went to the hospital for examination because she fainted last year. She found atrioventricular block. How should we treat her? Hua Wei: Atrioventricular block is also the cause of syncope. Pacemakers should be installed to prevent slow heartbeat and syncope. Moderator: Outpatient time cutie Thursday morning Hua Wei Thursday morning; Hospital Tel: (010) 68314466-8443.