Syncope is transient fainting due to decreased blood flow to the brain.

All the general information concerning the mechanisms causing unconsciousness, the symptoms and the different types of syncope are presented under the heading: The syncope, a dizzying subject.

Orthostatic syncope

Orthostatic syncope occurs when there is a decrease in pressure when a person goes from lying down to an upright position.

During this change of position, the effect of gravity causes the blood in the veins remains in the legs, causing a drop in pressure.

Everyone has once before felt a little dizziness from a drop in pressure after getting up too quickly. Normally, the body responds with mechanisms that quickly increase the pressure. However, when these are insufficient, the result is an excessive drop in pressure and syncope occurs.

Orthostatic syncope is more common in the elderly.

It is associated with certain medications (eg, antihypertensives, diuretics, and antipsychotics), nervous system diseases (eg diabetes, Parkinson's disease) and any condition that may lead to dehydration.

What tests can be requested?

The diagnosis is confirmed when the drop in pressure is demonstrated. To do so, it must be measured during the change in position, that is from the lying position to the upright one. The professional seeks for the appearance of the pre-syncope symptoms (dizziness).

What are the risks related to health?

As in other types of syncope, the risk of injury is present due to falls. The risks relating to health depend on the underlying condition, as the case may be.

What is the treatment?

As with vasovagal syncope, the easiest way to prevent syncope or injury is to lie on the floor.

The manoeuvers described earlier can also help (eg, crossing the legs).

Some tips

• In relation to an orthostatic syncope, it is very important to take your time when changing position. It is recommended to wait a few minutes while moving from lying down to sitting, then a few more minutes from sitting to standing. This allows the pressure to equilibrate and reduce the risk of syncope.

• In addition, the doctor evaluates the presence of the diseases mentioned above and modifies the medication accordingly. It is also important to avoid dehydration because, as we remember, it may cause a decrease in pressure.

• It is recommended to drink many fluids (2-3 liters per day) and not to restrict taking salt. In addition, during pre-syncope symptoms, rapidly drinking  cold water may help to relieve pressure.

• For people with hypertension and orthostatic problems when lying down, it is recommended to elevate the head of the bed by 10 degrees when sleeping.

• The patient can do so by placing either books or bricks under the legs of the head of the bed. This helps reduce the pressure in the lying position and leads to a less significant change in pressure when he or she stands after lying down for so long.

• If this advice is still insufficient, the doctor may prescribe medication to increase the pressure or modify the medication already prescribed.