What is syncope?

Syncope is a transient loss of consciousness.  Syncope is often referred to as a fainting spell.  Syncope may be a symptom of a serious life-threatening illness or a less dangerous condition. Diagnosing the cause for a faint is therefore extremely important.

What causes a syncope spell?

There are many potential causes of a syncopal spell.  These potential causes include abnormal fast or slow heart rhythms, abnormal heart valves, blockages in the arteries of the neck, stroke, seizures, low blood pressure, dehydration, and low blood sugars. 

How is a patient with syncope evaluated?

A cardiologist can sometimes determine the cause of a fainting spell by a thorough history from the patient and performing a physical examination.  The initial evaluation of a syncopal spell often includes an electrocardiogram, an echocardiogram and blood tests. The doctor may then wish to perform other tests which might include heart rhythm monitoring for a day or longer, stress testing, electrophysiology testing, cardiac catheterization or implantation of a battery operated monitoring device. A head up tilt table test is to diagnose the most common cause of syncope, neurocardiogenic syncope.

What is neurocardiogenic syncope?

Neurocardiogenic syncope is also known as vagal fainting, vaso-vagal fainting, or the common faint. This type of fainting is usually not life threatening unless it occurs while the patient is in a dangerous situation. Commonly, there are warning symptoms called a prodrome which include nausea, queasiness, sweating, light-headedness, and tunnel vision. Witnesses often say the person looks ashen and pale. If the patient can lie down and raise both feet, the episode often can be aborted. There are many possible triggers which can initiate this type of fainting. These triggers include the site of blood, needles, and pain.  Neorocardiogenic syncope is often diagnosed by a specific test known as a head up tilt table test.

How is syncope treated?

The treatment of syncope depends entirely on the cause.  For example, a syncopal spell may be caused by the heart beating too slowly (see bradycardia).  In this case, the treatment would be placement of a pacemaker.   Your cardiologist would help explain the best treatment option for you depending upon the cause of your syncopal spell.