Lipothymia, also called vasovagal syncope and neurocardiogenic syncope, is the medical name for common fainting caused by the body’s disproportionate reaction to a trigger (such as the sight of blood or emotional stress).

The mechanism behind it is simply an abrupt and drastic decrease in heart rate and blood pressure in response to the trigger, resulting in a consequent decrease in blood flow to the brain and a momentary loss of consciousness.

In most cases, lipothymia is harmless, does not require treatment and does not evidence any serious underlying problem. However, in some rare instances it may be due to more serious causes, such as cardiac or neurological conditions, and the physician may prescribe tests to rule out these reasons depending on the idiosyncrasies of the patient. In this regard, it is recommended to consult with the physician after a lipothymia.

Moments before loss of consciousness occurs, there may be a number of symptoms or prolegomena that herald it. These include pallor, dizziness, vision disturbances (narrowing of the visual field known as ‘tunnel vision’, blurred vision, double vision, flashes…), auditory disturbances (buzzing, whistling, sensation of remoteness with ambient sounds), nausea, sensation of heat, profuse sweating, mydriasis (dilation of the pupils), slow and weak pulse and abnormal movements.

During loss of consciousness, the person suffering from lipothymia often falls to the ground due to loss of muscle tone. This is the cause of the greatest danger of this phenomenon, as there is a risk of injury from the fall.

Recovery is progressive, but begins on its own a few moments after fainting.

The action to be taken when faced with lipothymia, in most cases, has more to do with first aid at the time of the phenomenon than with clinical treatment, since, as we have pointed out, this event is not usually serious. However, if in subsequent tests the physician detects any pathology, it will be necessary to treat it accordingly.

Immediately, the most important thing is to avoid the risk of falling by lying on the back or sitting with the head between the knees of the person who is beginning to feel the onset of lipotimia (if it occurs alone, it is best to lie on the back, even if it is on the floor). Loosening any fastened clothing or jewelry and elevating the legs above the rest of the body (no more than 30 cm) may help alleviate the symptoms.

The next step is to check that the person is breathing (in case of lipothymia if there is breathing; if not, there is a more serious problem). If this is not the case, CPR should be started and emergency services alerted.

After fainting, the affected person should be prevented from getting up abruptly and should ideally remain lying down for 15 to 30 minutes, otherwise he/she is at risk of suffering a new episode of fainting. Providing water or sugary drinks aids recovery.

If it has not been possible to prevent the fall and any obvious injury has occurred it should be treated accordingly (e.g. applying pressure to stop bleeding if present).

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