Syncope, Fainting And Your Heart

Even after a night at the bar, passing out and falling to the floor is not something that should be ignored the next day. When it comes to a syncope episode, passing out can be something more situational, resulting in an injury or an underlying heart condition that needs to be addressed.

Manoj Duggal, MD, a cardiologist with Franciscan Physician Network Cardiology Crown Point, explains what causes syncope and why it's essential to talk to a doctor.

What Is It Like To Experience Syncope?

Syncope, or fainting, is a temporary loss of consciousness caused by a sudden, temporary drop in the blood that flows to your brain. Still, there's a difference between a loss of consciousness and a syncope episode.

"A loss of consciousness is when somebody just loses consciousness, whereas syncope has added determinants," Dr. Duggal said. "Specifically, syncope is when somebody loses consciousness and their postural tone. The third component is they have a spontaneous recovery without intervention."

For example, a person with diabetes might lose consciousness due to an extremely low blood sugar and would need to have their blood sugars corrected to recover. In comparison, a person experiencing syncope will lose consciousness and recover spontaneously.

How Can I Tell When Syncope Causes Are Serious?

People can experience syncope from a combination of situational events or health-related concerns. Examples include:

• Sudden drop in blood pressure
• Dehydration
• Reduced heart rate
• Changes in blood amount across the body

While the causes of syncope can vary in levels of concern, it's essential to know the difference and when it's time to get help.

Vasovagal Syncope

Dr. Duggal explained that a series of events can result in reduced blood pressure generation, which can make you lose consciousness, regardless of your age.

"Generally, younger patients are more benign, whereas we get older have a heart condition, in, in other words, prognosis is much worse when you have heart conditions," Dr. Duggal said.

Dr. Duggal shared an example of a less concerning syncope episode.

"You may have seen people go to a restaurant with drinks and head to the bar while they wait for tables to open," Dr. Duggal said. "They'll have a drink, and next thing you know, they're on the floor. By the time everybody rushes in to help them, they have recovered. This scenario is more of a reflex-mediated syncope."

He also explained how a person may visit the emergency room, receive an IV and pass out from seeing a needle. This is considered vasovagal syncope, where the body overreacts to an experience, resulting in a drop in blood pressure and loss of consciousness.

Health-Related Syncope

Health-related syncope affects individuals with specific health conditions that impact their blood pressure or brain function.

Dr. Duggal explained that a person experiencing syncope can also be anemic, have low blood counts or other conditions such as Parkinson's.

"They have what we call as a autonomic dysfunction," Dr. Duggal said. "When they stand up, their blood pressure drops, resulting in them falling and passing out. When you're lying on a flat surface, your blood pressure gets better. Your brain starts getting blood and you regain consciousness."

Postural Syncope

Postural syncope happens when the body’s blood pressure drops after quickly standing up or lying down. This effect can happen depending on dehydration or even the medications you use.

Cardiac Syncope

When a person has a heart condition that affects how blood flows to their brain, it’s considered cardiac syncope. Some of these heart conditions that can cause syncope include:

• Heart failure
• Abnormal heart rhythm
• Poor blood flow
• Heart valve disease
• Blood clot
• Blood vessel blockage

"For example, there's a valve which connects the main pumping chamber of the heart," Dr. Duggal said. "In some people that valve can get very narrow as generally as they grow older, so the valve doesn't open even though heart is trying to pump. With generation of blood pressure, people can pass out. This can be very serious and can portray life-threatening conditions."

What Can I Expect During A Cardiac Test For Syncope?

After a syncope episode, your doctor will work to determine the cause and assess whether there are underlying concerns.

"With a patient that has passed out recently, their health history and recent syncope episode becomes very important," Dr. Duggal said.

Getting a diagnosis can require a cardiac test.

"With a patient that has passed out recently, their health history and recent syncope episode becomes very important," Dr. Duggal said.

These cardiac tests look for heart murmurs.

"If they have a heart murmur, that kind of tells me that their syncope episode may be a more serious condition," Dr. Duggal said. "The next thing most doctors do is an EKG, which gives a snapshot what your heartbeats are doing."

An EKG will help reveal if you have a slow heart rate. If it's confirmed as something serious, they'll order an echocardiogram to look at your heart valves and muscles.

"Sometimes we do all these tests, and we don't get any answers," Dr. Duggal said. "This is when we may give people a monitoring device like Holter monitors."

Dr. Duggal explained how heart monitor patches play a role in care following a syncope episode.

"We basically give a patient a patch for around 30 days that can give us clues following a syncope episode," Dr. Duggal said. "We can see if their heartbeat was too fast or too slow which can help reveal the potential cause for their syncope. And then of course, depending on what it is, we can offer treatment."

He also explained that some people have rare episodes of syncope, which can be twice a year or less.

"For rare syncope episodes, there are implantable monitoring devices where the batteries last for three years," Dr. Duggal said. "With these devices, we can correlate their symptoms to their heart rhythm."

Keep Your Provider Updated On Any Syncope Episodes

"If you pass out and you have a heart condition, you need to see your doctor right away," Dr. Duggal said.

He explained that it's essential to pay attention to your heart condition and current medications, as well as understand your family history, so you can share that information with your healthcare provider.