Syncope Analysis

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Syncope Analysis (Fainting)

Patients presenting with a history of blackouts, faints or collapse need careful evaluation to assess the precise nature of the problem.

Analysis of Syncope is essential so as to assess both the risk of a serious underlying disorder and also the risk of recurrence.

Etiology of Syncope

  • 1. Neurally mediated syncope (NMS) - also called Reflex syncope/Vasovagal syncope
  • 2. Orthostatic hypotension (postural hypotension) - syncope occurs after standing up
  • 3. Cardiac arrhythmias: Bradyarrhythmias, Tachyarrhythmias
  • 4. Other causes

Complications of Syncope

  • 1. Recurrent syncope has serious effects on quality of life.
  • 2. Morbidity is particularly high in the elderly and includes loss of confidence, reduced mobility, depression, fear of falling and bone fractures.
  • 3. Physical injury: soft tissue and bone injuries may occur due to fall.

Assessment and Investigations (Risk stratification)

  • 1. Blood pressure (Orthostatic)
  • 2. ECG (Detail analysis)
  • 3. Echocardiogram
  • 4. Treadmill test (TMT)
  • 5. Holter monitoring
  • 6. Head-Up Tilt Table (HUTT) testing
  • 7. External loop recording (ELR)
  • 8. Implantable loop recorder (ILR)
  • 9. EP study
  • 10. Cardiac MRI
  • 11. Coronary angiography (CAG)

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