What is Syncope?

Syncope is a sudden, complete loss of consciousness commonly described as fainting or passing out. In a typical syncope episode, a person will be standing and simply pass out with little to no warning. They will be unconscious for just a few minutes and may feel warm or appear flushed when they wake up. Syncope on its own may not be dangerous, aside from some risk of injury when passing out. However, there are some situations where syncope requires immediate medical attention, including:

• Syncope during exercising or while laying down,

• Palpitations or racing heart beat just before or during syncope,

• Syncope combined with family history of sudden cardiac death or a prior diagnosis of abnormal heart rhythm or EKG, or

• Syncope combined with resting heart rate below 50.

When a patient visits the Oklahoma Heart Hospital’s Heart Rhythm Institute following fainting spells or repeat episodes of passing out, their doctor will confirm if it is syncope, identify what is causing it, and run tests to rule out any underlying heart issues. The doctor will ask a series of questions, such as if the patient completely passed out, if the episode was fast and short, if they lost postural tone (collapsed), how many times it has happened, and if any other symptoms occur along with passing out. These questions will help the physician diagnose if it is truly syncope or another health concern. Tests may include an EKG to check the heart rhythm and an echocardiogram (ultrasound of the heart) to rule out any structural issues with the heart.

There are four primary categories of syncope:

• Reflex mediated syncope, which accounts for about 58% of cases. There are many sub-categories within reflex mediated syncope, but in general, this type of syncope occurs from a sudden drop in blood pressure.
• Syncope from underlying cardiac disease (23%). This may include a slow heart rate or fast heart rate, an electrical heart block, or many other heart rhythm issues.
• Neurologic or psychiatric syncope (1%).
• Unexplained syncope (18%).

Treatment options will vary greatly depending on each patient’s situation and the specific type of syncope diagnosed. For many patients, simply increasing water and sodium intake will reduce the frequency of syncope. Adequate hydration and sodium levels both help regulate blood volume, which in turn reduces the occurrence of syncope. Daily aerobic exercise is another factor that may help lessen the frequency of syncope. Other patients may require medication or even an implantable cardiac device, such as a pacemaker, for cardiac-related syncope.

If you have experienced repeat episodes of passing out, contact the Oklahoma Heart Hospital today to schedule an appointment with one of our physicians.