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Fainting painting

Consultant Neurologist, Department of Neurology, University Hospital of Wales, Cardiff, CF144XW, UK; E-mail: SmithPE{at}cardiff.ac.uk

EXTRACT

SYNCOPE

Fainting (syncope) is temporary loss of consciousness and posture due to impaired cerebral perfusion. Vasovagal syncope, the commonest form, typically is situational (bathroom at night, or hot, crowded environments) with specific triggers, e.g. prolonged standing, emotional trauma, pain, coughing, swallowing or micturition. Vasovagal syncope is generally benign, but fainting without provocation or warning, or for the first time in older individuals, suggests the more serious cardiac syncope – this must be investigated and managed urgently.

There are three phases to syncope: pro-drome, unconsciousness and recovery. The vasovagal syncope prodrome — light-headedness, nausea, sweating, blacking of vision — develops over 1–5 min. Unconsciousness lasts usually less than a minute, with pallor, sweating, cold skin, eyes open and elevated, and sometimes limb stiffness and convulsive jerks. Incontinence and injury are uncommon, and lateral tongue biting very rare. Recovery is prompt and any postictal confusion resolves in seconds.

SYNCOPE IN PAINTINGS

Although syncope is ...

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