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Syncope

Condition

Syncope is the medical term for fainting, sudden loss of consciousness for a short period of time

What is a Syncope?

 

The sudden loss of consciousness is an undoubted sign of sudden decreased blood flow to the brain. It is a serious condition with potentially life threatening causes.

 

Most reasons for a syncopal episode  are of cardiological nature because it is the heart which is responsible for blood flow to all our organs, incl. the brain.

 

The causes of sudden insufficient blood flow to the brain are numerous and all to be taken seriously. In most cases we are dealing with sudden arrhythmias which are not continuously present but rather on and off. A long pause > 3  sec. Between two heart beats is sufficient to decrease the blood flow to the brain significantly to cause a syncope. A very fast beat > 200 bpm or a quick change from very fast to very low may cause a short pause of the heart action.

 

Very slow heart beats as seen in AV-blocks or sudden, fast ventricular rhythms as often seen with other heart conditions like a heart attack, may all be the cause.

Syncope loss of consciousness condition

Acute drops in blood pressure to very low levels as seen in vaso-vagal dysfunction syndromes are a common cause especially in young, female adults.

Structural heart problems like a severe aortic valve stenosis (narrowing) or a HOCM cardiomyopathy are also common reasons for fainting or near fainting.

 

What are the symptoms of Syncope?

Sudden loss of consciousness with complete loss of all protecting reflexes. Patients drop to the floor and may injury themselves in the process. A monocle hematoma and other head and facial injuries are very common.

In some cases the patient may feel an attack coming and may be able to go down slowly. In other cases the attack is not severe enough to lose consciousness completely, rather a near-fainting sensation, also called pre-syncope.

 

What imaging/ tests are done to diagnose Syncope?

Most patients believe that the cause for their loss of consciousness must be primarily a brain problem and they almost always seek medical attention with the neurologist. Although the blood flow to the brain is indeed shut down causing the brain to faint, the cause is most commonly a cardiologic problem and needs urgent evaluation by a cardiologist.

It is very important to find the underlying cause of the syncope, because the treatment will differ depending on the diagnosis:

  • ECG-resting

  • 24h-7day Holter ECG

  • Bicycle Stress Test

  • Transthoracic Echocardiography

  • Implantable, continuous subcutaneous ECG monitors called loop recorder (for rarely occurring episodes  not picked up on a Holter monitor ECG)

  • Tilt table test

  • Carotid artery doppler-ultrasound

  • Minimally invasive EP-studies (electrophysiologic studies in the EP-lab)

 

What interventions/ treatments can be performed for Syncope?

Depending on the cause:

  • Medication

  • Pacemaker and defibrillator implantation

  • Coronary angiogram and stent insertion

  • Electrophysiologic ablation therapy

 

 

What interventions/ treatments does CardioCare offer for Syncope?

  • Medication

  • Pacemaker and defibrillator implantation

  • Coronary angiogram and stent insertion

  • Electrophysiologic ablation therapy

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