Syncope

What is syncope?

Syncope is temporary loss of consciousness and posture, described as “fainting” or “passing out.” It”s usually related to temporary insufficient blood flow to the brain. It”s a common problem, accounting for 3 percent of emergency room visits and 6 percent of hospital admissions. It most often occurs when the blood pressure is too low (hypotension) and the heart doesn”t pump a normal supply of oxygen to the brain.

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What tests are done to determine the cause of syncope?

The evaluation of a patient with Syncope begins with a history and a physical examination by a physician. If a dangerous cause is suspected, the patient may be admitted to the hospital until the precise cause is determined and treatment is begun. Most patients have the evaluation done as an outpatient. Finding the cause of a patient”s Syncope can be simple. Most often, the patient”s description of the faint, as well as his/her medical history can be enough to suggest the cause of Syncope. Often, however, we have to use tests to determine the exact cause. Based on the history, the evaluation of a patient with Syncope will be individually tailored to save time and expense. Since most patients have a cardio-vascular cause of Syncope, diagnostic testing begins with an evaluation of the heart using tests which are known to identify the cause of Syncope in large numbers of patients. The tests to be done and their sequences are carefully selected based on the patient”s presentation starting with simple, non-invasive.The common tests ordered by your physician may include ECG, echocardiogram, Hoter monitor, Event monitor, Tilt table test and Electrophysiology study

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Can syncope be dangerous? Should everyone who faints see a doctor?

Regardless of the cause of Syncope, anyone who loses consciousness is at risk for injury as a result of falling. Some patients with Syncope have warning signs and are able to lie down before they lose consciousness completely. Other patients may not have warning signs and may hurt themselves by falling unexpectedly. Even if a patient has a benign cause of Syncope, they may need treatment to protect them from the risk of losing consciousness recurrently. Because some types of Syncope are serious, all patients with Syncope should be evaluated by a doctor.

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What is vasovagal syncope?

Vasovagal Syncope is also called also neurocardiogenic, vasodepressor or reflex mediated Syncope. It”s a benign (and the most frequent) cause of fainting. Vasovagal Syncope (or neurocardiogenic Syncope) is more common in children and young adults, although it can occur at any age. It happens because blood pressure drops, reducing circulation to the brain and causing loss of consciousness. Typical vasovagal Syncope occurs while standing and is often preceded by a sensation of warmth, nausea, lightheadedness and visual “grayout.” If the Syncope is prolonged, it can trigger a seizure. Placing the person in a reclining position will restore blood flow and consciousness and end the seizure.

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What are the symptoms of vasovagal syncope?

The usual symptoms of vasovagal Syncope are dizziness, sickness, sweating or blurring of vision before the fainting attack. Although in some cases there may be no warning. The attacks can take from 5 minutes to a few hours to fully recover. Attacks when lying down are rare.

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What Causes Syncope?

There are many causes of Syncope. Some are due to significant heart disease, others are less serious. More than half result from a recognizable cardiovascular cause. Less commonly, Syncope is caused by noncardiovascular disorders such as dehydration, a low blood sugar, a stroke, a seizure, or as part of a panic attack. In patients with heart disease, Syncope often signals a mechanical or electrical problem. Mechanical causes of Syncope include blockage of one of the heart valves or abnormalities in the way in which the heart muscle contracts. The electrical rhythm disturbances that cause Syncope can be either very slow rhythms or very fast rhythms, both of which can be dangerous and require treatment. Syncope can also result from abnormalities of the reflexes that control heart rate and blood pressure.

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