Dizziness loss of consciousness. How to manage your own fainting? Educational video of the causes of loss of consciousness and types of collapse

Who has not experienced fainting spells in their life? And if he did not directly lose consciousness, then he certainly witnessed such cases with others.

Fainting - syncope or lipothymia - is an unconscious state of a person when he stops responding to the world around him (this condition can last from several seconds to several minutes). Fainting is called a sudden loss of consciousness, which is caused by a violation (decrease) of cerebral circulation.

There are extremely many reasons for this. A long list of diseases, some actions of the person himself, and possibly influences on him, can cause fainting. All diseases and causes (provoking factors) are even difficult to enumerate. Here are some of them: congenital heart defects - again, some, not all. For example, defects of the aortic valve, aorta, pulmonary artery. Heart rhythm disturbances are very different: both a sharp increase (tachycardia) and a significant slowdown in heart rate (bradycardia) are different heart blocks. A sharp change in body position from horizontal to vertical or prolonged standing (especially in a stuffy room) cause the so-called orthostatic collapse, or syncope. Hypoxia (acute lack of oxygen), severe anemia (low hemoglobin) and many more reasons can cause loss of consciousness. But most often there are so-called vascular syncope.

How to understand that you are in a state of fainting?

Fainting has an aura, that is, occurs after some precursors. The body, as it were, warns you: I feel bad, uncomfortable, then it can be even worse! These precursor signs include nausea, flickering of "flies" before the eyes, ringing in the ears, weakness in the legs. Outwardly, it looks like this: you turn pale or even gray, cold sweat appears on your forehead (and not only), the pulse is frequent (if it's just a vascular faint), weak, the pressure drops sharply, the pupils are dilated. If the syncope is deep (more than five minutes), even convulsive phenomena may occur, but should not be confused with an epileptic seizure, there are completely different reasons.

How to behave if your relatives or acquaintances are in a faint?

It is advisable to lay the unwell, and so that the head is lower than the legs. If it is impossible to lay down (situations are different - an elevator, a car and other small spaces), then by all means sit down and tilt your head forward. In a number of cases, this is already enough, since the blood circulation in the brain is revived, intensified, and the “patient” comes to his senses. You can give a sniff of ammonia (you can also use cologne), rub the whiskey. Then do the following manipulations - thoroughly, until redness, rub the victim's auricles (without ceremony, without being delicate). Then you can act very energetically on the hands (the point between the base of the thumb and forefinger - it turns out the top of a kind of triangle). Try it on yourself: you need to find a point that will be painful, and press on it, making circular movements with your finger pressed to this point, press hard, taking your hand with your hand.

I have to do this quite often, because next to my office there is a treatment room where blood is taken from a vein. Most often, teenage boys and caring dads faint (take, mind you, the blood is not from them, but from the child!)

That is, all these measures are well tested and, believe me, they work: they bring a person to consciousness and increase the overall tone. Just remember that we are talking about vascular syncope.

If you have a tendency to faint and pre-syncope, I strongly recommend that you get an examination. You need to start with an examination by a therapist (or a pediatrician, in the case of a child), who will refer you to a neurologist (it is imperative to conduct an ultrasound scan of the vessels of the head and neck, simply ultrasound), to a cardiologist (ECG, HOLTER - daily ECG monitoring) to exclude various heart rhythm disturbances that can cause syncope.

The volume of examinations can be expanded, but this is already according to indications (for example, MRI of the brain, ultrasound of the heart, and so on). As already mentioned, vascular syncope is often preceded by an aura (harbinger symptoms), and by knowing these, if you are prone to syncope or pre-syncope, you can take preventive measures and prevent the development of syncope.

There are special techniques - the so-called isometric loads with crossing the legs or tensing the arms. Such maneuvers can cause an increase in blood pressure (it drops significantly, as you remember), and therefore increase cerebral circulation and thus interrupt the development of fainting.

And it happens that it’s enough just to sit down or squat down and lower your head down. There are also trainings to get rid of vascular syncope, associated mainly with orthosis (standing, often for a long time). The name of this method is "tilt test", training by standing for a long time with a gradual increase in time. This is effective, but you need to be patient, because a positive result is far from immediately obtained.

In any case, if you are prone to fainting, I advise you to definitely consult a therapist, neurologist and cardiologist.

Loss of consciousness in patients with is observed infrequently, except in cases where dizziness is associated with hemodynamic disturbances. Patients with vasovagal, cardiogenic (with arrhythmias), or orthostatic (due to orthostatic hypotension in diseases of the autonomic nervous system) syncope often experience dizziness before losing consciousness.

Therefore, at history taking it is necessary to clarify the presence of concomitant heart diseases, episodes of palpitations or a feeling of pressure in the chest and other signs of cardiac pathology. Hypersensitivity of the carotid sinus can cause syncope when the neck is compressed or twisted. Of course, in the presence of these symptoms, priority should be given to cardiac rather than otoneurological examination. However, it should be noted that given the high prevalence of cardiovascular disease and vestibular disorders, it is not surprising that they often coexist in the same patient.

Sweating, feeling heat or chills, wet palms, bilateral tinnitus or blackouts have been noted in patients with episodes of hypotension, such as vasovagal syncope or orthostatic hypotension. Surrounding people notice that the patient turns pale before losing consciousness. As a rule, consciousness returns to patients a few seconds after the fall, as the cerebral blood supply is restored.

At repeated episodes of patients often identify triggers and can prevent loss of consciousness by lying down or sitting up with their head between their legs. Frequent provoking factors are staying in a hot, stuffy room, fright (for example, at the sight of blood), pain, prolonged standing in an upright position, quickly getting up from a lying or sitting position, etc. In many patients, clinical manifestations are limited to dizziness in combination with the symptoms described above , and actually fainting (that is, loss of consciousness and falling) does not happen.

Such presyncope syndromes(lipothymia) can cause serious diagnostic difficulties, even when using formal tests for the state of the autonomic nervous system. Therefore, the clinician should actively investigate the presence of trigger factors, a history of loss of consciousness, and the effect of lying or sitting (positive for lipothymia).

At hypoglycemia(taking hypoglycemic drugs for diabetes mellitus, in rare cases - insulin-secreting tumors), dizziness and fainting are possible. Most patients with diabetes are familiar with the symptoms and know how to manage them (eating). Recall that the study of the concentration of glucose in the blood is a mandatory measure in all cases of loss of consciousness of unclear etiology.

Vestibular epilepsy is a rather vague concept. It has been known since Penfield's classic work that direct electrical stimulation of the temporal cortex can cause rotational vertigo. Isolated cases of systemic dizziness have been described in acute vascular lesions of the temporal lobe, in addition, it is well known that short-term systemic dizziness can be an aura of an epileptic seizure.

However isolated recurrent dizziness, not accompanied by other epileptic phenomena, cannot be considered a manifestation of epilepsy. The term "vestibular paroxysms" (or paroxysmia, see Chapter 4) is used to describe brief episodes of dizziness and/or oscillopsia that are caused by irritation of the vestibular nerve or nuclei in the brainstem; no loss of consciousness occurs.

Finally, some patients it is sometimes reported that during severe vertigo in the acute phase of vestibular neuritis or Meniere's disease, it seemed to them that they were losing or lost consciousness. It is very difficult to know for sure what is going on in such situations; however, it can be assumed that the acute onset of new frightening symptoms, aggravated by panic or dehydration (in the presence of vomiting), may lead to presyncope or syncope, especially in predisposed patients.

surrounding it is usually reported that contact with the patient was difficult, but possible, that is, complete loss of consciousness does not occur.

Educational video of the causes of loss of consciousness and types of collapse

In case of problems with viewing, download the video from the page

- Return to the section heading " "

memory lapse
Loss of consciousness
Dizziness
Fainting

Fainting (syncope)- this is a short-term loss of consciousness and a fall against the background of a sudden decrease in metabolism in the brain. Most often, such a decrease occurs as a result of a short-term violation of cerebral blood flow and, consequently, a lack of oxygen to the brain. This leads to dizziness or loss of consciousness. A temporary deterioration in the blood supply to the brain can be caused by heart disease or other causes that do not directly affect the heart.

Fainting is always accompanied fainting state- a person experiences a feeling of lightheadedness, circles before the eyes, palpitations, pounding in the temples, sweating, hot flashes, nausea, a feeling of an impending fall. If you do not sit down in time, then there is a loss of consciousness and a fall. The loss of consciousness is short-term (several seconds), and the person quickly comes to his senses, being in a horizontal position. Rarely, short-term twitching of the limbs, loss of urine and other symptoms occur.

Causes leading to a decrease in cerebral blood flow and fainting:

1. Violation of the autonomic nervous system, leading to improper regulation of vascular contractility - the cause of neurogenic syncope (more than 50% of all syncope)

2. Pathology of the heart - the cause of cardiogenic syncope (make up 25% of all syncope)

3. Vascular disorders (significant atherosclerotic deposits in the vessels of the head and neck, transient ischemic attacks, strokes)

4. Sudden increase in intracranial pressure (tumor, hydrocephalus, hemorrhage)

5. Decrease in the content of oxygen, sugar, electrolytes in the blood (hypoxia, anemia, hypoglycemia, renal and liver failure)

6. Decrease in the volume of circulating blood (bleeding, excessive urination, diarrhea)

7. Poisoning (carbon monoxide, alcohol, etc.)

8. Mental disorders (hyperventilation syndrome, hysterical neurosis)

9. And also distinguish other forms of loss of consciousness - as a result of epilepsy, traumatic brain injury, infections, etc.

Consider the most common types of syncope: neurogenic, cardiogenic, hyperventilatory.

Neurogenic syncope:

1. Vasodepressor - occurs in young people in certain situations - with pain, fear, emotional stress, the sight of blood, stuffiness, prolonged standing; vasodepressor syncope accounts for the vast majority of syncope of all types

2. Orthostatic - occurs when standing up abruptly, taking certain medications (antihypertensive, antidepressants, levodopa)

3. Syncope with increased sensitivity of the carotid sinus - occurs in elderly men with atherosclerosis and arterial hypertension when wearing tight collars

4. Fainting with increased intrathoracic pressure - occurs during nighttime urination in older men, with coughing, defecation

Cardiogenic syncope occur with heart rhythm disturbances, conduction blockade, myocardial infarction.

Hyperventilatory syncope occur during an attack of anxiety, fear, panic attack (vegetative crisis) as a result of unconscious acceleration and deepening of breathing.

With bradycardia(when the heart rate is below 60 beats per minute) there may be short-term bouts of loss of consciousness (seconds) - "walk-walk - came to myself lying on the floor." It is important to note that the change in the frequency of contractions should be sharp and fast, up to 20-30 beats per minute. An attack of bradycardia may be preceded by a feeling of "heat in the head." Such fainting states are caused by a sharp decrease in the blood supply to the brain and are characteristic of various types of arrhythmias.

Diseases that can cause fainting

aortic stenosis
Dehydration
Diabetes
Low blood pressure
Migraine
Parkinson's disease
Pulmonary hypertension
Hit

Possible causes of fainting

Violation of the autonomic nervous system
Heart pathology
Sudden increase in intracranial pressure (tumor, hydrocephalus, hemorrhage)
Poisoning (carbon monoxide, alcohol, etc.)
Mental disorders (hyperventilation syndrome, hysterical neurosis) Epilepsy
Traumatic brain injury

Causes of loss of consciousness

Fainting is most often caused by causes that do not directly affect the heart:
Postural (orthostatic) hypotension: a decrease in blood pressure due to a change in body position to an upright position after lying or sitting;
Nerve pain in the legs in the elderly (especially those with diabetes or Parkinson's disease)
high altitude
Fainting in certain situations (situational syncope), such as:
Taking blood
Urination
defecation,
swallowing, or
Coughs that cause an involuntary nervous system reflex (vasovagal response) that slows down the heartbeat and dilates the blood vessels in the legs, making the person feel nauseous, sweaty, and weak shortly before fainting.

Causes related to the heart: heart conditions that can cause fainting or loss of consciousness:
Abnormal heart rhythm (heart beats too fast or too slow).
Anomalies of the heart valves (aortic stenosis or stenosis of the pulmonary valve).
High blood pressure in the artery supplying the lungs (pulmonary artery hypertension).
Aortic dissection.
Widespread diseases of the heart muscle (cardiomyopathy).

Medications can cause unconsciousness by changing blood pressure or by affecting the heart.

Syncope in children and adolescents, vasovagal

Vasovagal syncope in children and adolescents usually develops due to stress, fatigue, or hunger, so avoiding these conditions is recommended.

Vasovagal syncope accounts for about 50% of all syncope. They are common in healthy people and often occur repeatedly.

Vasovagal syncope is provoked

Excitement (in this case, they often develop in a stuffy, crowded room),

Fear (for example, at the dentist's office),

overwork,

injury or

Often, fainting develops for no apparent reason.

Classical vasovagal syncope is accompanied by arterial hypotension, bradycardia, nausea, pallor, and profuse sweating.

The mechanism of fainting is as follows. In response to a decrease in venous return and a decrease in stroke volume, sympathetic tone reflexively increases. In persons predisposed to such fainting, such an increase in sympathetic tone is excessive, and this leads to a sharp increase in cardiac contractility. From the mechanoreceptors of the ventricles along the afferent fibers of group C of the vagus nerves, intense impulses enter the medulla oblongata, and this is accompanied by a decrease in sympathetic and an increase in parasympathetic tone. As a result, excessive peripheral vasodilation and relative bradycardia develop, which leads to a fall in blood pressure and syncope. Consciousness is quickly restored in the supine position with legs raised.

A test on an orthostatic table (prolonged stay at an angle of 60-80 *) can provoke fainting in such patients. Isoprenaline at low doses increases the sensitivity of this test, but at high doses it can lead to false positive results.

Vasovagal syncope sometimes occurs in response to a sharp pain, especially coming from the internal organs. Occasionally, it accompanies a migraine attack.

Urinary syncope is more common in older men during and after urination, usually after sleep. It may be a type of vasovagal syncope. A decrease in pressure in the bladder causes vasodilation and bradycardia due to an increase in parasympathetic tone.

Which doctor should I contact if fainting occurs:

Cardiologist
emergency doctor
Gastroenterologist

Differentiate between orthostatic hypotension and hypertension. Orthostatic hypotension is a common lesion of the autonomic nervous system.

This disease is most common in elderly patients. Such a disease is also characterized as a syndrome that manifests itself in various neurological and somatic diseases.

Orthostatic hypertension is often a manifestation of nephroptosis, in which blood pressure rises when a person is in an upright position. This disease is observed in 85% of patients suffering from nephroptosis. This is a characteristic symptom of renovascular nephrogenic hypertension.

However, in comparison with vasorenal hypertension, orthostatic hypertension develops with intense physical exertion and a change in body position.

Therefore, when the patient is in an upright position, his condition is normal, because due to the contraction, the diameter and length of the renal artery become the same, and the angle between the aorta and arteries increases.

In a healthy body, when the body changes from a horizontal to a vertical position, compensatory reactions are triggered in the cardiovascular system, which is accompanied by a gravitational movement of blood.

These processes are necessary to maintain normal blood circulation in the brain. Orthostatic circulatory failures occur due to insufficient compensatory reactions, they are a response to orthostasis.

It is noteworthy that some doctors believe that orthostatic hypotension and hypertension are not diseases, but a condition that occurs when the vessels cannot maintain a normal level of pressure. The reasons for this phenomenon are manifold:

malnutrition;
disruption of the endocrine system;
stress;
infectious diseases;
intoxication, accompanied by hyperhidrosis, vomiting and stool disorder;
blood loss;
taking diuretics, antihypertensives, vasodilators for a long time.

However, the main factor leading to loss of consciousness is ischemic anoxia. It develops when the myocardium cannot provide a full cardiac output.

In this case, the heart rhythm is disturbed, due to which it cannot provide sufficient cerebral perfusion. There is also a decrease in pressure, the reasons for this lie in peripheral vasodilation, in which blood flow in the brain worsens.

In orthostatic hypertension, pressure often rises due to the presence of nephroptosis due to a change in body position or physical activity.

Symptoms

Orthostatic hypotension is characterized by such manifestations as:

sweating;
malaise;
darkening in the eyes;
hearing loss;
blurry vision;
dizziness.

But the leading sign of hypotension is syncope, which occurs when blood pressure is greatly reduced, as a result of which blood flow also worsens and neuronal metabolism is disturbed. This condition is also called postural hypotension.

The clinic of loss of consciousness is stereotyped. That is, fainting occurs against the background of the same conditions. Often, the patient gets dark in the eyes in the morning and in the evening, when he abruptly changes the horizontal position to the vertical one. But as soon as the patient assumes a horizontal position, his general condition and blood pressure level are normalized.

Postural hypotension with loss of consciousness and dizziness is often the only symptom of a disease such as orthostatic idiopathic hypotension.

It is characterized by constantly developing autonomic failure, when the preganglionic neurons of the lateral horns of the spinal cord are affected. In severe cases of the disease, patients are forced to comply with bed rest, since any change in body position leads to fainting.

Orthostatic hypertension is accompanied by symptoms such as discomfort in the lower back, headache. Often the disease is accompanied by angiospastic retinopathy.

Diagnostics

To confirm or refute the presence of orthostatic hypertension and hypotension, it is necessary to study the history and drugs taken by patients, identify influencing factors and examine organs and systems using percussion, auscultation, palpation and other methods.

The active orthostatic load is also checked. To do this, the patient changes position (lying-sitting). During this, the skeletal muscles take part in hemodynamic adaptation to orthostasis, which is strongly pronounced even if the musculature voluntarily relaxes.

But most often the Schellong test is done, which makes it possible to exclude the participation of skeletal muscles in orthostatic adaptation.

The procedure takes place on a rotating table. Thus, the patient's body is passively transferred to a semi-vertical and vertical position.

An orthostatic test makes it possible to study the patient's condition, measure blood pressure and heart rate. If the upper pressure decreases by 20 units, and the lower one by 10 or more, then this confirms the presence of orthostatic hypotension, in particular, when this condition is accompanied by fainting. In addition, the course of the disease is indicated by the loss of muscle tone and collapse.

It is worth noting that if the patient is over 60 years old, then the pressure is measured not only in a sitting or lying position, but also when the patient is standing for five minutes. The fact is that in older people, orthostatic hypertension often develops against the background of treatment with hypertensive drugs.

Moreover, to establish an accurate diagnosis, it is necessary to conduct an instrumental and laboratory study.

It is equally important to distinguish manifestations of hypotension and hypertension from ordinary syncope. So, a simple loss of consciousness is different in that when it occurs in similar situations, over time it becomes not very pronounced, and then disappears altogether.

Signs of orthostatic hypertension and hypotension are almost always expressed in the same way. Consequently, people with pressure problems always know exactly what conditions lead to fainting, and in other situations it is not always possible to determine when they will happen.

In addition, simple loss of consciousness often occurs when a person is in a trochanteric position, and in hypotension and hypertension, it occurs when a change in position. Even fainting often develops against the background of physical activity.

Also, with a normal loss of consciousness, the skin becomes warm and moist, and warmth is felt throughout the body, which is not the case in the case of low or high blood pressure.

Treatment

Often, the treatment of orthostatic hypotension comes down to taking medications containing caffeine. Also, the doctor may prescribe medications containing hormones that affect the endocrine and nervous systems.

With orthostatic hypertension caused by nephropathy against the background of functional stenosis of the renal artery, surgical intervention is indicated - nephropexy. During such treatment, the kidney is fixed in a physiological position by laparoscopic or open access.

In addition, proper nutrition plays an important role in the treatment of orthostatic hypertension and hypotension. So, the diet should be nutritious, light, with limited salt intake, enriched with useful vitamins and trace elements. The video in this article will continue the topic of hypotension.

on the

How is tinnitus related to high blood pressure?

Ah, this sea romance! You press the shell to your ear and - here it is - the sea, which is always with you! But, unfortunately, the causes of noise or ringing in the ears are far from being so romantic and, most often, are a symptom of a serious illness or a temporary deviation, which also does not cause great joy.

Noise in the ears - to treat or wait?

Tinnitus is one of the most common reasons for visiting a doctor. Despite the fact that many patients wait before seeking help, from a few weeks to several years. Calculation on "maybe" is especially characteristic of the Russians. And there are cases when everything really goes by itself. But which specialist should I contact if tinnitus takes on a persistent annoying character?

What are the symptoms talking about?

Increased susceptibility to loud sounds indicates a nervous breakdown or recent stress;
The monotonous nature of the noise and a noticeable deterioration in the quality of sounds - it is advisable to check the circulatory system and exclude inflammatory processes in the ears;
Pulsating ringing or noise in the ear indicates problems with high blood pressure;
Weakness, dizziness, loss of consciousness speaks of hypotension;
Vomiting, nausea are signs of Meniere's disease;
Fever, earache, diagnosed with otitis;
Dizziness, lack of coordination, the nature of the noise is constant with localization in one ear - suspicion of damage to the auditory nerve.

Of course, the first thing that comes to mind in this case is an appeal to an ENT doctor, since the health of the hearing organs comes into question first of all. In some situations, this assumption is true and the patient has a deviation in the work of any auditory organ.

However, these causes of the appearance of noise or ringing in the ear are not exhausted. Almost every person has heard something similar more than once in his life and would like to know the nature of this discomfort.

The origin of noise is explained by many factors:

Diseases of the vessels of the brain and ENT organs

Perhaps this is the most common reason for patients complaining about tinnitus. After an examination of the ENT by a doctor, during which the cause is not revealed, the patient is sent for examination to a neurologist, where he may be assigned additional studies:

Complicated blood flow in some vessels of the brain entails a lack of nutrition and oxygen starvation of the brain area supplied by this vessel, causing extraneous sounds in the ear or head. For example, narrowing of the vascular lumen due to stenosing atherosclerosis or aneurysms and neoplasms in various parts of the brain.

Diseases of the cardiovascular system

In terms of importance, this reason, of course, comes first. But in practice, patients suffering from pressure drops get used to periodic tinnitus and rarely turn to specialists about this.

Ringing in the ears, due to cardiological problems, accompanying pressure fluctuations, occurs both in hypotension and in hypertensive conditions.

With low blood pressure, characteristic of vegetative-vascular dystonia, common among young girls and women, in addition to ringing, they usually appear: weakness, dizziness, narrowing of vision, pallor, loss of consciousness. The reason for a sharp decrease in pressure can be: stuffiness, a reaction to high air temperature (for example, a sauna), blood loss, oxygen starvation, drugs.

No less often, tinnitus accompanies an increase in blood pressure. In addition to the above symptoms of pressure changes, with a hypertensive crisis, migraine-like headaches in the back of the head, nausea, vomiting, intense redness of the skin are added.

Violation of vascular tone of a psycho-emotional nature

Patients in this group include young people and middle age. In our stressful time of excessive psycho-emotional stress, there are noticeably more such appeals. As a rule, examinations do not reveal any deviations of a physiological nature. Those who seek help are prescribed sedatives with a relaxing, calming effect.

Bringing the autonomic nervous system back to normal relieves most of the symptomatic manifestations, which confirms the psycho-somatic nature of the occurrence of disorders.

What to do about ringing in the ear?

First of all, it is necessary to measure blood pressure, and in dynamics. With frequent conditions of high pressure, more than 140/90 mm Hg, regardless of whether there is ringing in the ears, immediately contact a cardiologist or your local therapist. If the noise effects occurred precisely during the increase in pressure, it is possible that after its normalization they will disappear.

In the case of normal pressure indicators, you should contact an otorhinolaryngologist to confirm or exclude a local ear disease. In most cases, during the examination, the cause of the noise is found.

If the causes of noise effects are not found, the patient is usually referred for further examination to a neurologist. Unfortunately, for patients who cannot tolerate the discomfort of constant noise, research procedures and treatment by a neurologist will cost quite a tangible amount, but there is no other way to diagnose and fix the problem. Only this way: Doctor - diagnosis - recommendations - implementation - doctor.

How to take BP readings correctly?

In a healthy person, blood pressure is normally 120/80 mm Hg. 120 - an indicator of the upper systolic pressure, 80 - the lower diastolic pressure or the frequency of myocardial contractions in one minute, driving the blood flow through the vessels. When the numbers on the tonometer deviate by 5-8 mm. in one direction or another, the error is considered within the normal range for a healthy person.

If the indicators deviate up or down from 9 divisions and above, this is the reason for keeping a diary of the patient's pressure indicators.

For a true picture of the real state, it is recommended to measure pressure at least twice a day, at the same hours, and enter the indicators in a diary, indicating the date and time of measurement. You can also make brief comments on how you feel at this moment, for example, the presence of tinnitus, weakness, headache, and the like.

Particular attention should be paid to the environment in which the patient takes measurements. Do not perform the procedure on a patient who is in an overexcited state, immediately after eating or with a full bladder, standing or after sports exercises, as well as in a stuffy or cold room.

The person needs to be comfortably seated on a chair, calmed down, the hand should be conveniently positioned for applying the cuff, the elbow should be placed at the level of the heart. Subject to all the rules, you can count on the reliability of the results.

When there is noise in the ears of a smoking person, this may be due to spasmodic, after a cigarette, cerebral vessels and it is necessary to observe whether the appearance of sounds coincides in time with smoking breaks.

In any case, if the noise in the head and ears is repeated regularly, causes anxiety and discomfort, you should not delay a visit to the doctor. A timely appeal to a specialist will dispel false fears and prevent a serious illness from developing.

Dizziness: why it occurs, manifestations and diseases, how to get rid and cure

Normally, a person's sense of balance is provided by the vestibular apparatus, which is located in the inner ear in the cavity of the temporal bone and has the shape of a labyrinth. The functions of this paired organ are reduced to processing information about the position of the body at a given moment in time and about its position relative to surrounding objects. Information from the receptors of the labyrinth instantly enters the brain and cerebellum, which give electrical signals to the muscles that support the body in a particular position and give the body the necessary position.

Disturbances in the blood supply to the brain and inner ear, inflammatory diseases of the ENT organs, injuries and other processes can cause changes in the interconnected work of the organ of vision, the vestibular apparatus, the brain and skeletal muscles. This can lead to loss of balance and comfortable movement in space due to dizziness (vertigo).

According to statistics, only 30% of patients go to the doctor because of dizziness, half of them suffer from frequent and prolonged bouts of imbalance.

What causes dizziness?

Vertigo can be caused by both fairly harmless causes, and serious diseases that require a doctor's consultation.

Factors that can cause dizziness:

Prolonged rotation on a carousel or swing - often occurs in children due to a sharp interruption of impulses from the inner ear to the brain. A child who runs in circles for a long time may also feel dizzy. Associated with the functional immaturity of the vestibular apparatus in children before the onset of adolescence;
Kinetoz - motion sickness in a car, train, when traveling by water transport. More often occurs in children under 13 - 14 years old, among the adult population - in 7 - 10%;
Decrease in blood flow to the brain due to low blood pressure during severe stress, emotional and mental overstrain, during the period of hormonal changes in adolescence, in individuals with vegetative-vascular dystonia;
A sharp release of adrenaline into the blood during a pain reaction, severe fright, quarrel, strong positive emotions can cause dizziness;
Physical overwork, constant lack of sleep, malnutrition (exhausting diets, starvation, vegetarianism);
Pregnancy, especially in the first and third trimester. Moderate short-term dizziness during pregnancy is absolutely normal, since a change in the level of certain hormones in the blood of a pregnant woman leads to a slight decrease in pressure. In the later stages, the blood supply to the enlarged uterus and the growing fetus is carried out to a greater extent than the upper body, so less blood flows through the vessels of the brain. In addition, large vessels in the abdominal cavity are clamped by the uterus - the inferior vena cava, the aorta;
A sharp change in the position of the head or the whole body, for example, when you feel dizzy when you get up from a sitting position - orthostatic hypotension occurs, that is, a temporary decrease in blood pressure due to blood flow to the muscles of the lower extremities under the influence of gravity;
Being at a height can cause an attack of dizziness due to the inability to focus on near and far objects;
Side effects or overdose of certain drugs - diphenhydramine, tavegil, amikacin, gentamicin, painkillers, cardiac drugs, tranquilizers, antidepressants, etc. Almost any drug has dizziness in the list of side effects;
Smoking causes spasm of blood vessels, including cerebral vessels, and the use of alcohol and drugs has a direct effect on the areas of the brain responsible for coordination and a sense of balance.

Diseases associated with dizziness

Depending on whether a pathological process has occurred in the inner ear or not, systemic (true, vestibular) and non-systemic (non-vestibular) vertigo are distinguished.

Systemic dizziness is characterized by a clear sensation of rotation of objects around the body or rotation of the body itself in space and occurs when the vestibular apparatus or nerve nuclei of the brain responsible for coordination and balance are affected. It occurs in 25% of all cases of symptoms described by the patient as a condition in which the head is spinning. In the rest - signs of non-systemic dizziness.

Systemic vertigo is characteristic of diseases such as:

Meniere's disease - as a rule, a unilateral lesion of the labyrinth of a non-inflammatory nature;
Vestibular schwannoma (benign tumor), or acoustic neuroma;
Bacterial and viral diseases of the labyrinth - labyrinthitis due to untreated otitis media, after influenza, measles, rubella;
Acute peripheral vestibulopathy (vestibular neuronitis) is a complication after an acute respiratory infection in the form of damage to the vestibular apparatus;
Benign paroxysmal (paroxysmal) dizziness - in 50-75% of cases, the cause of such attacks cannot be established, then they speak of idiopathic dizziness. It is characterized by the occurrence of seizures at night or in the morning at the slightest turn or tilting of the head. Attacks are short-term, occur several times a day or a week, then cease to disturb the patient for several weeks, and then reappear;
Damage to the brain in the region of the vestibular nuclei and the cerebellum - tumors, injuries, stroke in the acute and subacute periods.

Non-systemic vertigo is characterized by various symptoms described by the patient as a feeling of dizziness, nausea, unsteady gait, fainting with flies before the eyes and tinnitus and can occur with such diseases:

Neurological diseases - epilepsy, demyelinating (multiple sclerosis), infectious (meningoencephalitis), tumor processes of the brain, increased intracranial pressure;
Psychogenic diseases - neurosis associated with constant stress, depression, anxiety personality disorder;
Diseases of the middle and inner ear - otitis media, barotrauma (may occur in divers, divers with a sharp dive to a great depth), acoustic neuroma;
Diseases of the visual apparatus - diabetic retinopathy (retinal pathology), cataracts, glaucoma;
Diseases of the musculoskeletal system and the associated violation of blood flow through the vessels of the neck and head, for example, with cervical osteochondrosis or the consequences of a spinal injury in the cervical region, the carotid arteries that bring blood and oxygen to the cranial cavity suffer;
Cerebral circulation disorders - acute (stroke) and chronic (dyscirculatory encephalopathy);
Diseases of the heart and blood vessels - sick sinus syndrome, bradycardia, atherosclerosis of the aorta and carotid arteries, arterial hypertension and hypertensive crisis;
Migraine;
Early and late consequences of traumatic brain injury;
Pathological conditions that occur during pregnancy and not only - preeclampsia (preeclampsia), anemia, low blood glucose levels, lack or absence of vitamins in the body.

If you have eliminated all factors that provoke dizziness, and unpleasant symptoms persist, you should consult a doctor to conduct an examination for a disease that could cause such a condition.

Video: doctor about systemic and non-systemic dizziness

In what diseases can dizziness be combined with other symptoms?

Dizziness and hearing impairment are most common in diseases of the inner ear or damage to areas of the brain in the region of the vestibular nuclei or cerebellum. In addition to sensations of rotation of the body in space or surrounding objects around the patient, there may also be pain in the ear on the affected side, leakage of fluid or pus from the ear canal, tinnitus, distorted perception of sound by the ear on the affected side. Sometimes dizziness and hearing loss can be observed during treatment with ototoxic antibiotics - amikacin, gentamicin, streptomycin, etc.

Dizziness and nausea almost always occur together, and the patient at such moments is disturbed by a general feeling of weakness, fatigue, dizziness, it gets dark in his eyes, there is a "lump" in the throat, sweating, a feeling of lack of air. Such attacks are characteristic of any condition or disease that caused dizziness. Often the patient complains that he is sick, dizzy when getting up or when lying down, in a state of hangover.

Dizziness and vomiting. If severe dizziness, and even more true, is combined with severe nausea, repeated vomiting, headache in the back of the head or in the temporal region, you should immediately measure blood pressure and consult a doctor. Such conditions can occur with a hypertensive crisis or a sharp decrease in pressure. Persistent daily vomiting, especially in the morning on an empty stomach, together with frequent dizziness may indicate a tumor process in the brain. With a tumor, one should think about the malignancy of the process if the patient notes frequent dizziness, prolonged and rapidly progressing attacks of true vertigo.

Dizziness with osteochondrosis can be not only in the elderly, but also in young people. The latter fact is due to the fact that young people, students, office workers spend most of their working day at the computer, in almost the same position, and this cannot but affect the functions of the cervical vertebrae. Pathological processes in them lead to muscle spasm and compression of the vertebral arteries, which worsens the blood supply to the brain.

In older people, in addition, the carotid arteries are often affected by atherosclerotic plaques and cannot provide a full flow of blood to the head. Dizziness with osteochondrosis occurs more often in the morning, with a sharp rise, turning the head or changing the body in bed. It can be combined with headaches, sleep disturbance, impaired attention, absent-mindedness, forgetfulness, frequent mood swings. These are symptoms of poor blood flow in the brain.

Weakness and dizziness with normal blood pressure may indicate chronic fatigue, psychogenic illness, Meniere's disease. Also, these symptoms occur with a decrease in blood glucose levels in people with diabetes, with anemia, starvation, vitamin deficiency in food. During pregnancy, this condition is often observed in an absolutely healthy woman.

Dizziness and neurological symptoms. Loss of sensation in the extremities, asymmetry of the face, inability to maintain a sitting or standing position, speech disturbances combined with severe dizziness and or even loss of consciousness may indicate an impending or already developing acute stroke.

Dizziness and impaired coordination of movement are found in tumors of the cerebellum. In addition to the fact that the patient is dizzy, there is an instability of gait, tilts to the side when moving or sitting, an unnatural position of the head, headache of the occipital localization, sideways movement of the eyeballs (nystagmus), visual and speech disorders.

Dizziness and headache occur with overwork, prolonged work at the computer or watching TV, with constant emotional stress, especially combined with anxiety. Often severe headache in one half of the head and face with severe dizziness are observed with migraine. In addition to pain and dizziness, the patient is disturbed by photophobia, lacrimation, increased headache from harsh sounds, unpleasant odors, impaired visual perception of objects (change in their shape or color), impaired sensitivity of the skin of the fingers and toes, tingling or burning sensations in them.

Which doctor should I contact for dizziness?

If you suspect a disease that can cause dizziness, you should consult a general practitioner, an ENT doctor, a neurologist, you may need to consult a cardiologist, a vertebrologist (a doctor who treats the spine).

The doctor, in addition to examination, hearing test (audiometry), assessment of coordination and neurological status, prescribes the necessary examination methods, such as:

Complete blood count to determine the level of hemoglobin,
Blood glucose test,
Duplex scanning of vessels of the head and neck,
ECG, ultrasound of the heart in case of suspected cardiovascular pathology,
Electroencephalography for suspected epilepsy
Echoencephalography for suspected traumatic brain injury,
CT, MRI of the brain for suspected acute stroke, tumor process, multiple sclerosis,
X-ray, CT or MRI of the cervical spine.

If all possible causes of true vertigo are ruled out, it is possible that the patient has benign positional vertigo. To diagnose this disease, a Dix-Hallpike test is performed - the patient sits down on the couch, turns his head to the left or right, then the doctor, holding the patient's head with both hands, sharply lays him on the couch on his back so that his head hangs from the couch. The occurrence of nystagmus (rapid movements of the eyeballs) or the occurrence of true dizziness indicates a positive test result.

It should be remembered that self-diagnosis in cases of prolonged, often occurring dizziness, especially true, is unacceptable. It is necessary to consult a doctor in a timely manner, since in the case of a serious cause of this condition, it is important to establish a diagnosis and start the correct treatment as soon as possible.

How to get rid of dizziness?

Treatment for vertigo begins with avoiding the factors that cause it and treating the underlying disorder that caused it.

To eliminate the causative factors, you should:

Lifestyle changes needed:

Quit smoking and alcohol,
Proper nutrition with a sufficient amount of vitamins, trace elements, carbohydrates, proteins in food,
Compliance with food intake
Compliance with a rational regime of work and rest, with sufficient night sleep (at least 8 hours).

You can stop the attack of dizziness with the help of simple tricks:

You need to take a sitting or lying position, in extreme cases, lean against the wall, look without looking up at any object, without closing your eyes, breathe deeply and calmly,
Open a window for fresh air,
Perform a massage of biologically active points that improve blood circulation in the areas associated with them and are located near the inner edges of the eyebrows, near the wings of the nose, on the earlobes. To do this, within 5 - 6 minutes, you need to press your finger in the indicated places in a circular motion.

Therapeutic measures in the presence of a causative disease include:

Drug treatment of circulatory disorders, injuries, anemia, diabetes mellitus, diseases of the eyes and ears,
Prescribing anti-migraine drugs (amigrenin, amigril),
Appointment of drugs that improve blood supply to the brain (cinnarizine, cavinton), nootropic drugs (nootropil, piracetam),
Massage courses, physiotherapy exercises for diseases of the spine,
Surgical treatment of a brain tumor,
The appointment of psychotropic drugs for neurosis, depression, etc.

To relieve symptoms with constant dizziness, the doctor prescribes the following drugs:

Histamine receptor agonists - betahistine and its analogues - betaserc, tagista, vestibo, betaver, etc.;
Antiemetics - metoclopramide, cerucal;
Antispasmodics - scopolamine, etc.

It is important to remember that dizziness tablets can only be used on the advice of a doctor, since each drug has clear indications and contraindications.

Are dizziness possible?

Dizziness itself is not a life-threatening condition, however, it can be dangerous for the patient when, for example, he is dizzy at high altitude, on an escalator, on a steep staircase, next to the side of a sea vessel, etc. The danger in such situations is that a person with dizziness can lose balance and fall, causing serious injury to himself.

If the patient has adapted to the fact that he is often and very dizzy, and does not go to the doctor, this is fraught with the fact that in case of any causative disease, it progresses, and the patient does not receive proper treatment, which can lead to complications, lack of effect from late treatment, etc.

Video: dizziness in the program "Doctor I .."

Fainting is caused by a temporary loss of blood supply to the brain and may be a sign of a more serious illness...

Temporary loss of consciousness - fainting

Fainting is a temporary loss of consciousness.

Fainting is caused by a temporary loss of blood supply to the brain and may be a sign of a more serious illness.

People of any age can faint, but older people may have more serious causes.

The most common causes of fainting are vasovagal (a sharp decrease in heart rate and blood pressure) and heart disease.

In most cases, the cause of fainting is unknown.

Fainting can have many different causes:

Vasovagal syncope also known as "general weakness". This is the most common cause of fainting due to an abnormal vascular reflex.

The heart pumps more vigorously, the blood vessels relax, but the heart rate does not compensate fast enough to keep blood flowing to the brain.

Causes of vasovagal syncope:

1) environmental factors (more often when it's hot);

2) emotional factors (stress);

3) physical factors (loads);

4) illness (fatigue, dehydration, etc.).

situational syncope only happens in certain situations.

Causes of situational syncope:

1) cough (some people faint with a strong cough);

2) when swallowing (in some people, loss of consciousness is associated with a disease in the throat or esophagus);

3) when urinating (when a susceptible person passes out with an overflowing bladder);

4) hypersensitivity of the carotid sinus (in some people when turning the neck, shaving or wearing a tight collar);

5) Postprandial syncope can occur in older people when their blood pressure drops about an hour after eating.

orthostatic syncope occurs when a person feels fine in a lying position, but when he gets up, he may suddenly faint. Brain blood flow decreases when a person is standing due to a temporary drop in blood pressure.

This syncope sometimes occurs in people who have recently started (or received a replacement for) certain cardiovascular medications.

Orthostatic syncope can be due to the following reasons:

1) low circulating blood volume caused by blood loss (external or internal blood loss), dehydration, or heat exhaustion;

2) impaired circulatory reflexes caused by drugs, diseases of the nervous system, or congenital problems. Cardiac syncope occurs when a person loses consciousness due to cardiovascular disease.

Cardiac causes of syncope are usually life-threatening and include the following:

1) anomaly of the heart rhythm - arrhythmia. Electrical problems in the heart impair its pumping ability. This leads to a decrease in blood flow. The heart rate may be too fast or too slow. This condition usually causes fainting without any warning.

2) cardiac obstacles. Blood flow may be obstructed in the blood vessels in the chest. Cardiac obstruction can cause loss of consciousness during exercise. Various diseases can lead to obstruction (heart attacks, diseased heart valves in pulmonary embolism, cardiomyopathy, pulmonary hypertension, cardiac and aortic tamponade).

3) heart failure: the pumping ability of the heart is impaired. This reduces the force with which blood circulates in the body, which can reduce blood flow to the brain.

neurological syncope may be associated with neurological conditions.

Its reasons are:

1) a stroke (bleeding in the brain) can cause fainting associated with a headache;

2) transient ischemic attack (or mini-stroke) can cause loss of consciousness. In this case, fainting is usually preceded by double vision, loss of balance, slurred speech, or dizziness;

3) in rare cases, a migraine can cause fainting. Psychogenic fainting. Hyperventilation due to anxiety can lead to fainting. The diagnosis of psychogenic syncope should only be considered after all other causes have been ruled out.

Syncope symptoms

Loss of consciousness is an obvious sign of fainting.

Vasovagal syncope. Before fainting, a person may feel light-headed; blurred vision will be noted. A person can see "spots before the eyes."

The patient has pallor, dilated pupils, and sweating.

During a loss of consciousness, a person may have a low heart rate (less than 60 beats per minute).

The person must quickly regain consciousness. Many people do not have any warning signs before fainting.

Situational fainting. Consciousness returns very quickly when the situation passes.

Orthostatic fainting. Before a fainting episode, a person may notice blood loss (black stools, heavy menstruation) or fluid loss (vomiting, diarrhea, fever). The person may also be delirious. Observers may also note pallor, sweating, or signs of dehydration (dry lips and tongue).

Cardiac fainting. The person may report palpitations, chest pain, or shortness of breath. Observers may note weakness, irregular pulse, pallor, or sweating in the patient. Fainting often occurs without warning or after exertion.

Neurological fainting. The person may have a headache, loss of balance, slurred speech, double vision, or dizziness (feeling like the room is spinning). Observers note a strong pulse during the unconscious period and normal skin color.

When to seek medical help?

Since fainting can be caused by a severe condition, all episodes of loss of consciousness should be taken seriously.

Any person, even after the first episode of loss of consciousness, should see a doctor as soon as possible.

Depending on what the physical examination reveals, the doctor may require tests to be done.

These tests may include: blood tests; ECG, daily monitoring, echocardiography, functional stress test. Table tilt test. This test tests how your body reacts to changes in position. Tests to detect problems of the nervous system (CT of the head, MRI of the brain or EEG).

If the person next to you has fainted, help him.

Lay it on the ground to minimize the chance of injury.
Stimulate the person actively and call 911 immediately if the person does not respond.
Check the pulse and start CPR if necessary.
If the person recovers, let him lie down until the ambulance arrives.
Even if the cause of fainting is not dangerous, have the person lie down for 15-20 minutes before getting up.
Ask about any symptoms such as headache, back pain, chest pain, shortness of breath, abdominal pain, weakness, or loss of function because these may indicate life-threatening causes of fainting.

Syncope treatment

Treatment for fainting depends on the diagnosis.

Vasovagal syncope. Drink plenty of water, increase your salt intake (under medical supervision), and don't stand for long periods of time.

Orthostatic fainting. Change your lifestyle: sit down, flex your calf muscles for a few minutes before getting out of bed. Avoid dehydration.

Elderly people with low blood pressure large meals should be avoided after meals, or plans should be made to lie down for a few hours after meals. In most cases, you should stop taking drugs that cause fainting (or replace them).

Cardiac fainting. To treat cardiac syncope, the underlying disease must be treated.

Valvular heart disease often requires surgery, while arrhythmias can be treated with drugs.

Medications and lifestyle changes.

These procedures are designed to optimize the performance of the heart, control of high blood pressure is necessary; in some cases, antiarrhythmic drugs may be prescribed.

Surgery: bypass surgery or angioplasty are used to treat coronary heart disease; in some cases the valves can be replaced. A pacemaker may be implanted to normalize the heart rate (slows the heart for fast arrhythmias or speeds up the heart for slow arrhythmias). Implanted defibrillators are used to manage life-threatening rapid arrhythmias.

Syncope Prevention

Preventive measures depend on the cause and severity of the fainting problem.

Fainting can sometimes be prevented by taking simple precautions.

If you are weak because of the heat, cool the body.
If you faint while standing (after lying down), move slowly while standing. Slowly move into a sitting position and rest for a few minutes. When you are ready, stand up using slow and fluid movements.

In other cases, the causes of fainting may be elusive. So see your doctor to determine the cause of fainting.

After determining the cause, treatment of the underlying disease should begin.

Cardiac syncope: due to the high risk of death from cardiac syncope, people who experience it should be treated for the underlying disease.

Periodic fainting. Consult a doctor to determine the causes of frequent loss of consciousness.

Prognosis due to syncope

The prognosis for a person who has fainted depends largely on the cause, the age of the patient, and the treatments available.

Cardiac syncope has the greatest risk of sudden death, especially in the elderly.
Syncope that is not associated with cardiac or neurological disease is a more limited risk than in the general population.

Checking the pulse in the neck. The pulse is well felt only near the throat (trachea).

If a pulse is felt, note if it is regular and count the number of beats in 15 seconds.

To determine the heart rate (beats per minute), multiply this number by 4.

The normal heart rate for adults is between 60 and 100 beats per minute.

If you fainted only once, then you don't have to worry about it.

It is important to see a doctor because fainting can have serious causes.

Fainting can be a sign of a serious problem if:

1) It often happens within a short period of time.

2) it occurs during exercise or vigorous activity.

3) fainting occurs without warning or in a supine position. In mild syncope, the person often knows that it is about to happen, vomiting or nausea is noted.

4) a person loses a lot of blood. This may include internal bleeding.

5) there is shortness of breath.

6) there is pain in the chest.

7) the person feels that his heart is pounding (palpitations).

8) Fainting occurs along with numbness or tingling in one side of the face or body. published .

If you have any questions, ask them

The materials are for informational purposes only. Remember, self-medication is life-threatening, consult a doctor for advice on the use of any medications and treatments.