Syncope/Fainting

Syncope, or fainting, is a common symptom in healthy children, teenagers, and adults. The majority of patients with syncope do not have cardiac causes, however in a small select number of people syncope can be a sign or symptom that is secondary to an abnormal heart condition.

Syncope/Fainting Q & A

What causes syncope (or fainting) in patients?

Syncope, or fainting, is a common event that can be the result of many different issues and can involve several different of the body's autoregulatory systems. The majority of patients with syncope do NOT have cardiac causes. Examples of non-cardiac syncope can include:
· Sub-optimal hydration or dehydration
· Sub-optimal regulation of the nervous system (dysautonomia)
· Seizures or head trauma
· Low blood sugar
· Inner ear dysfunction
· Psychiatric manifestations

Alternatively, cardiac causes of syncope are often quite dangerous and can cause significant morbidity and mortality. There are several cardiac causes of syncope in patients that can be alarming and puts patients at an increased risk for sudden death. A few examples of cardiac syncope include:
· Heart muscle diseases (cardiomyopathy)
· Abnormal heart rhythm
· Infection of the heart

What are the symptoms of cardiac syncope?

There are several symptoms of cardiac syncope that are concerning. The presence of these symptoms warrant alarm and should prompt evaluation by a physician immediately. If needed, activity should be restricted until cleared by a cardiologist. These symptoms include:
· Syncope occurring during intense physical activity
· Chest pain, especially during intense physical activity
· Excessive and persistently elevated heart rate, especially during intense physical activity

Cardiac evaluation of syncope

To screen for cardiac causes of syncope, the cardiologist will obtain a detailed history to characterize symptoms associated with syncope, perform a detailed cardiac examination, measure blood pressure / heart rate responses with postural changes, and order an electrocardiogram (ECG). If the initial screening reveals concerning elements to cardiac syncope, additional evaluation such as an echocardiogram or cardiac monitor can be performed.