What is Syncope?

Syncope is commonly known as fainting. It occurs when the brain does not receive enough oxygen, causing you to temporarily lose consciousness. The most common forms of syncope are cardiogenic, neurocardiogenic and orthostatic, all of which involve underlying heart, cardiovascular or blood pressure issues. 

Baptist Health is known for advanced,superior care for patients with heart disease and the diagnosis and treatment of syncope. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Prior to fainting, other signs and symptoms of Syncope may include: 

• Going pale/loss of skin color
• Lightheadedness
• Blurred or tunnel vision
• Nausea 
• A cold, clammy sweat
• Chest tightness
• Shortness of breath
• Heart palpitations 

Diagnosis

To determine if a patient has syncope, the physician will ask questions about family history and symptoms and listen to the patient’s heart with a stethoscope. Additional testing to determine if the fainting episodes are being caused by something more serious may include:

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Electrophysiology study: This test records the heart’s electrical activities and pathways. It can help find what’s causing heart rhythm problems and identify the best treatment. 

Event monitor: This portable EKG device records the heart rate when a button is pressed. It can be worn for weeks or until symptoms occur.

Holter monitor: This portable EKG device continuously records the heart’s rhythms and is worn for 24 to 48 hours during normal activity.

Stress testing: This test is conducted during exercise. If a person can't exercise, medicine is given to increase heart rate. Used along with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure. Exercise makes the heart work hard and beat fast while heart tests are administered. 

Causes

Fainting associated with syncope can have many triggers. Some of the more common causes include: 

• Heat exposure
• Standing for long periods of time
• Seeing blood or having blood drawn
• Straining to have a bowel movement
• Running or other strenuous exercise
• Extreme fear, panic, or other situational stressors
• Standing up too quickly
• Medications that lower blood pressure

Risk Factors

In addition to the causes of syncope, there are several other risk factors:

Age: Syncope is most common in children, young adults and the elderly.

Heart conditions: Heart conditions such as coronary artery disease, cardiomyopathy, heart arrhythmias, a weak heart or signs of heart failure, or a prior heart attack may increase your risk for syncope.

Prevention

Syncope can usually be prevented by avoiding triggers. Reducing heat exposure, especially when engaged in strenuous activity, drinking plenty of fluids, not standing too long, and avoiding things that cause stress will help prevent this condition.

Prognosis

While syncope is not usually serious, it could be indicative of a more serious condition. Those who experience frequent episodes or changes in the frequency of episodes should see a doctor to determine if there are more serious underlying causes.

Treatment and Recovery

Your doctor may help you identify your fainting triggers and discuss ways you might avoid them, but in most cases further treatment is unnecessary. If, however, your condition begins to interfere with your quality of life, your physician may suggest the following:

Medications

Medications may be prescribed to treat low blood pressure or regulate the central nervous system, which may reduce the occurrence of syncope.

Lifestyle Changes

Your doctor may recommend lifestyle changes, including:

• Foot exercises, wearing compression stockings, and tensing your leg muscles when standing may reduce the risk of some forms of syncope.
• Increase salt in your diet if you don't usually have high blood pressure
• Avoid prolonged standing — especially in hot, crowded places
• Drink plenty of fluids

Surgical Options

If your syncope is caused by rapid, slow, or erratic heart beats, your physician may recommend implanting a surgical pacemaker or defibrillator.

Complications

Complications from syncope arise when fainting spells result in serious injury. Those prone to should avoid triggers, and use caution when engaging in activities such as driving, swimming, operating heavy machinery, or participating in extreme sports or thrill-seeking activities.