Health Resource Center
Syncope
Aug 20th 2008
Syncope
or fainting is a very common reason for patients to see cardiologists. There
are many causes for syncope, but most episodes relate to alterations in blood
pressure or heart rate. Other cardiac causes of syncope can include primary arrhythmias,
either slow or fast. In some cases, syncope can be a malfunction of the nervous
system that controls blood pressure and heart rate.
Upon initial evaluation, many patients with syncope can
have their problem diagnosed with a minimum of additional testing. If other
testing is required it is likely to include tests of the heart such as echocardiograms
and stress
testing. Frequently a Holter
or event monitor may be ordered to evaluate for arrhythmias. A tilt may be recommended to evaluate for a special kind of syncope
called neurocardiovascular syncope. Rarely, an electrophysiology
test may be needed.
Treatment for syncope depends on the cause and varies
greatly. In many cases, syncope can be prevented with simple non-medication
maneuvers such as salt supplementation or avoiding situations that provoke
syncope such as prolonged standing. Additionally, recognizing the early
symptoms indicating that syncope is likely to occur can allow for maneuvers
such as lying down which can prevent an episode. In some cases medications may
be recommended. These can include special steroids, beta-blockers, proamatine
(a medication that increases blood pressure), stimulants, and
serotonin-reuptake inhibitors (anti-depressants). The wide variety of
medications utilized for syncope indicates the many possible causes and the
complexity of blood pressure control. There are some instances in which pacemakers
or defibrillators are indicated.
Most cases of syncope can be diagnosed and treated by a
general cardiologist. In more complex cases sub-specialty cardiologists called
electrophysiologists may be consulted particularly if advanced testing and
treatment is needed.
Click here to learn more about syncope.