If you have experienced repetitive fainting episodes, your doctor may recommend further diagnostic tests to ascertain the underlying causes since these symptoms may indicate Syncope.
It is essential to understand that Syncope is not just another episode of loss of consciousness, although fainting is relatively common and not life-threatening.
Why Does Syncope Occur & What Are the Common Symptoms?
Syncope is very similar to fainting. You may experience partial or complete loss of consciousness and an unawareness of your surroundings. A full recovery to a conscious state usually follows it.
Repetitive syncopal episodes may indicate an underlying heart condition requiring a permanent pacemaker implantation. However, the seriousness of the condition can only be determined through proper diagnosis and treatments to prevent further episodes.
Most often, fainting episodes may occur due to extreme physical exertion, sweating or dehydration [called common fainting]. However, Syncope can occur without any warning, although sometimes, the symptoms before a syncopal episode can manifest as:
- Nausea or dizziness
- Sweating or clamminess
- Visual disturbances
- Low heart rate and blood pressure
- Extensive yawning
- Headaches
- Blackouts
- Fainting after a meal or workout
- Unsteadiness when standing
- Tunnel vision or seeing black spots
Whether symptoms appear or not, you must consult your doctor since syncope may indicate neurological or cardiac diseases. Let’s explore these details further.
Syncope & Its Connection to Heart Health
Generally, fainting occurs due to one or multiple reasons, such as:
- Decreased flow of blood to the brain
- Failure of the heart to pump blood
- Inadequacy of the blood vessels to maintain the right blood pressure [low BP] to facilitate blood flow to the brain.
- Lack of adequate fluid or blood in the vessels.
The reasons for these are temporary and situation-based. However, when a heart abnormality causes fainting, the situation becomes more complex and may become fatal with any one of the following conditions:
- Bradycardia -Slower than average heart rate (less than 60 beats per minute).
- Tachycardia -Faster than average heart rate (more than 100 beats per minute).
- Blockage in the heart vessels
- Narrowing of heart valves
Only a thorough diagnosis can explain the cause of your Syncope, based on which your doctors can determine the right course of treatment.
Also Read : Pacemakers: Saving Your Heart One Beat At a Time
What Causes Syncope: The Primary Risk Factors
Older adults who experience syncope due to cardiac issues are most likely to be hospitalised, especially if they are men over 60 years of age. However, the situation may not be the same for younger people experiencing syncope. They may faint while standing or due to certain stressful situations. The risk of cardiac syncope is significantly high for those with:
- Prior arrhythmic episodes [prior heart rhythm abnormality]
- Brief palpitations
- Low ventricular function
- One or two fainting episodes
- Abnormal cardiac exam
- Genetic predisposition to cardiac issues
- Existing congenital heart diseases
- Family history of sudden cardiac death below fifty years of age
- Ischemic heart disease [old heart attack, prior CABG surgery /Angioplasty]
- Structural heart diseases
- Sudden loss of consciousness during exertion or when lying flat on one’s back.
It's essential for anyone experiencing syncope to undergo a diagnostic assessment, which includes a thorough physical examination, a review of medical history, and measurement of blood pressure and heart rate.
Diagnostic Tests to Determine Causes of Syncope
If your doctor suspects cardiac syncope, he may recommend the following tests for further diagnosis:
- ECG- To record the heart’s electrical signals, abnormal rhythms and cardiac issues.
- Treadmill Tests or TMT: Tracks heart rhythms while you walk on the treadmill.
- Tilt Table Test: Assessment of your heart rhythms and blood pressure in various positions.
- Basic blood tests: Includes Complete Blood Count tests to check for anaemia that causes syncope.
- Holter Monitor tests: It is a device that tracks your heart rhythm during routine activities for one or two days.
- Extended Rhythm Monitoring: To detect intermittent heart rhythm issues through a monitoring device for one or two weeks
- Insertable Loop recorder: Tracks and identifies rhythm issues [up to three years] that cause syncopal episodes.
- EPS or Electrophysiology Study: To examine your vulnerability to abnormal rhythms under controlled conditions.
- Electroencephalogram [EEG]: Helps diagnose seizures by measuring your brain’s electrical activity.
- MRI or CT Brain Scan: Helps to evaluate neurological conditions causing syncope
- Autonomic Reflex Testing: Monitors blood pressure, heart rate, and responses to stimuli.
Syncope itself is not a disease but a warning of imminent issues. However, the best management for Syncope is preventing them by avoiding instances that trigger loss of consciousness.
Simple Tips to Prevent & Treat Common Syncope
It doesn’t take much to save yourself from experiencing fainting spells. Here are some simple lifestyle modifications that will help alleviate syncopal episodes.
- Eat on time and do not skip any meals.
- Hydrate yourself adequately.
- Avoid physically exerting yourself in hot weather, especially if you are prone to fainting.
- Take the prescribed medications on time, especially if you have diabetes or cardiovascular diseases.
- Inform your doctor if you experience dizziness after taking your medication.
- Follow simple home remedies to keep your BP in check. Stay hydrated and maintain an appropriate level of sodium intake.
- If your syncope is due to cardiac issues, that can be life-threatening and your doctor may suggest implanting a device to manage irregular heartbeats.
If your syncopal episodes are repetitive, it is best to consult your cardiologists & electrophysiologists, neurologists or general practitioners for medical help. Cardiologists and electrophysiologists specialise in syncope evaluation related to heart-related ailments, while neurologists treat issues related to the nervous system.
Why You Should Visit Syncope Clinics
It is important to seek assistance from a syncope clinic for a comprehensive assessment of fainting episodes. A syncope clinic offers specialised testing and monitoring, ensuring a thorough evaluation to determine the underlying cause and create an effective management plan. While many incidents can be diagnosed through a detailed history and physical examination, some may go unnoticed without witnesses. Typically, a single fainting episode may not require extensive investigation or treatment, especially at a young age, but prevention of future episodes can be achieved by avoiding known triggers. On the other hand, even one episode of syncope related to cardiac ailment can be life-threatening and detailed evaluation and treatment is needed to prevent sudden cardiac arrest.
After receiving hospital or outpatient care, scheduling a follow-up appointment within 2-4 weeks is crucial to monitor progress and address concerns. Further follow-up appointments will be necessary if any structural or rhythm abnormalities in the heart are identified.
Dr. Karthigesan established the syncope clinic concept first in India to evaluate, educate, and treat recurrent syncope patients. However, continuous assessment is essential for managing and minimising the risk of future syncopal episodes. If you are experiencing any of the above-mentioned symptoms, kindly consult Dr. Karthigesan, the leading electrophysiologist in Chennai.
Contact us to book your appointment. Prioritise your heart health.
