Syncope (patient information)

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What is syncope?

How do I know if I have syncope?

Syncope itself is a symptom. Patients with syncope may feel:

Temporary loss of consciousness
Blacking out
Light-headedness
Dizziness
Grogginess, feeling unsteady or weak when standing, even falling

Who is at risk for syncope?

Cardiac causes

Arrhythmia, such as ventricular tachycardia, sick sinus syndrome, long Q-T syndrome
Abnormal constructure in cardiovascular, such as aortic stenosis, aortic dissection, hypertrophic cardiomyopathy.
Hypertension

Brain causes

Vasovagal syncope: This is the most frequent and benign cause of syncope.

How to know the reason of your syncope?

The goal of the following is to make sure the cause of your syncope.

Lab tests

Complete blood count, liver function, renal function and serum electrolyte levels
Cardiac enzymes

Echocardiography: In patients with known heart disease, echocardiography is needed to check the heart structure and assess left ventricular function. It uses sound waves to produce an image of the valves, ventricles and atrium. The image shows the structure of the mitral valve and its movement during the beating of the heart.
Electrocardiogram (ECG), Holter monitoring and electrophysiologic studies: Electrocardiogram and Holter monitoring can tell electric activities of the heart. They can supply informations about heart rhythm and indirectly, heart size. It may help doctor determine the relationship between syncope and arrhythmia. Compared to Holter monitor, electrophysiologic studies have a higher diagnostic yield, it needs to order to any patient with a suspected arrthymia.
Head images: Head images such as CT and MRI, may be useful to check brain diseases that cause syncope. A CT scan can show brain structureand locate lesions and its surrounding tissues. An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body.
Tilt table test: This test help reveal abnormal cardiovascular reflexes that produce syncope. During the test, you stand and your initial blood pressure and heart rate are recorded as the baseline. Then the table is tilted at 70 degrees for 45 minutes. Your blood pressure and heart rate are recorded again. At the same time, the nurse observes whether the patient appear symptoms such as nausea or vomiting. A positive result suggest the possibility of vasovagal syncope.