What is cardiac syncope?
Cardiac syncope is a sudden loss of consciousness caused by the heart’s inability to pump enough blood to the brain. As blood flow to the brain briefly decreases, fainting occurs. It usually happens suddenly, lasts a short time, and recovery is often rapid.
Under normal conditions, your heart continuously pumps enough blood to maintain consciousness. If your heart rate becomes too slow, too fast, or if the heart’s pumping ability suddenly drops, blood flow to the brain can decrease. When this happens, fainting may occur.
These episodes often develop abruptly and may happen without warning. For this reason, cardiac syncope requires more careful evaluation than many other causes of fainting.
What are the symptoms of cardiac syncope?
Before fainting, you may experience:
- dizziness
- blurred or darkened vision
- palpitations
- chest tightness
- sudden weakness
- cold sweating
In some cases, fainting can occur suddenly without any warning signs.
The loss of consciousness is usually brief. Most people regain consciousness within seconds to a few minutes. Afterward, you may feel tired, weak, or lightheaded for a short period.
When to see a doctor?
Cardiology evaluation is essential if:
- fainting occurs suddenly without warning
- you faint during physical exertion
- palpitations or chest pain accompany the episode
- fainting episodes recur
- a fall or injury occurs
- there is a family history of sudden cardiac death
If fainting is associated with severe chest pain or sudden loss of consciousness, seek emergency medical care immediately.
What causes cardiac syncope?
Cardiac syncope may be caused by:
- arrhythmias
- heart valve disease
- heart failure
- diseases of the heart muscle
- certain congenital heart conditions
How is cardiac syncope diagnosed?
Diagnosis begins with a detailed medical history and physical examination. An electrocardiogram (ECG) is usually performed to evaluate heart rhythm.
If needed, additional tests may include:
- ambulatory rhythm monitoring (Holter monitor)
- heart ultrasound (echocardiography)
- exercise stress testing
- tilt table testing
The goal is to directly identify the heart-related cause of fainting.
How is cardiac syncope treated?
Treatment depends on the underlying cause.
If a heart rhythm disorder is identified, treatment options may include:
- medications
- pacemaker implantation
- implantable rhythm-regulating devices
- cardiac ablation
If valve disease or a structural heart problem is present, surgical or interventional treatment may be required.
The main goal is to eliminate the cause of fainting and prevent future episodes.
What are the risks of cardiac syncope?
Because cardiac syncope may be associated with serious heart conditions, it can carry significant risk. Untreated rhythm disorders, in particular, may increase the risk of sudden cardiac arrest and sudden cardiac death.
For this reason, anyone who experiences cardiac syncope should be evaluated promptly and followed closely.
Living with cardiac syncope
After diagnosis and treatment of cardiac syncope, you should:
- attend regular follow-up visits
- take prescribed medications consistently
- avoid sudden position changes
- maintain adequate fluid intake
If you have a history of fainting, it is important to follow your doctor’s advice regarding driving and working in high-risk occupations.
Reference: Cardiac Syncope
