What is syncope?

Syncope, commonly referred to as fainting, is a common medical condition characterized by temporary loss of consciousness. It typically occurs as a symptom of underlying heart conditions such as coronary artery disease, bradycardia or atrial fibrillation.

Syncope affects more than 3 percent of men and women in the United States at some point during their lives. It is more common as people age and can affect more than 6 percent of people 75 years old and older.

Causes of syncope

Syncope typically occurs when the heart or blood vessels are not functioning correctly and oxygen-rich blood can’t get to the brain.

Although syncope can be caused by a benign medical condition, it can also be a sign of a serious, potentially life-threatening condition.

Conditions that could cause syncope include:

  • Bradycardia
  • Tachycardia
  • Blood flow obstruction

Risk factors for syncope

Although anyone can suffer from syncope, people over the age of 80 are at higher risk of death from the condition. A variety of conditions put people at higher risk for developing syncope. Conditions include:

  • Coronary artery disease
  • Chest pain caused by angina
  • Cardiomyopathy
  • Some congenital heart defects
  • Long QT syndrome
  • Previous heart attacks

Symptoms of syncope

Typically, if you experience syncope, you are not aware that you have fainted. Before you faint, you may feel the following symptoms:

  • Lightheadedness
  • Nausea
  • Sweaty
  • Weakness
  • Dizziness
  • Tingling sensations in the body
  • Muffled hearing

Diagnosis of syncope

You should visit your doctor after experiencing syncope if you have chest pains, have a history of heart disease, you are pregnant, you have diabetes or were unconscious for more than a few minutes.

If you think you have syncope, your diagnosis can be confirmed in a physical exam with your doctor. Your doctor will take a full medical history and determine what you were doing when the episode occurred.

Diagnostic testing may be done to determine the underlying cause of your episode. Diagnostic testing may include:

  • Complete blood count (CBC) — blood tests can show the underlying cause of syncope.
  • Electrocardiogram (EKG or ECG) — an electrocardiogram or portable EKG can detect abnormal heart rhythms. 
  • Echocardiogram — an imaging modality that can detect underlying heart issues that could be causing the fainting episodes. 
  • Exercise stress test —  an ECG while you are exercising will evaluate the condition of your heart while you are exercising.
  • Tilt table test — if other testing does not identify the cause of your syncope, your doctor may recommend a tilt table test to see if the changes in your body position causes your symptoms.

Treatment for syncope

Most cases of syncope will not need to be treated by a healthcare provider. After an episode, you should sit (with head between the knees) or lie down and drink fluids to restore normal function.

You should be evaluated by your doctor to determine if there is a serious cause of your episode. If your doctor deems treatment necessary, treatments should address the underlying cause of the condition. Treatment protocol will vary based on the underlying cause.

Treatments for syncope include:

  • Education — to prevent occurrences, education about importance of staying hydrated, proper salt intake and recognizing pre-syncope signs can all help prevent future episodes. 
  • Medications — medications can help manage irregular heart rhythms or other underlying conditions that are causing symptoms. 
  • Pacemaker — if you have bradycardia, your doctor may recommend you have a pacemaker implanted that will deliver an impulse if the heart rate drops too low. 
  • Catheter ablation — if your syncope is caused by tachycardia, a catheter ablation may be necessary to relieve your symptoms of syncope. 
  • Cardioversion — a cardioversion can restore normal heart rhythm after a tachycardia arrhythmia. 
  • Implantable cardioverter defibrillator (ICD) — an ICD can monitor the heart rhythm and restore normal rhythm after ventricular fibrillation.

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