S Y N C O P E TO

ING O U T. SO M E O NE IS CONSIDERED
R PASS
E) IS  ANO TH ER W O RD FOR FAINTING O CO VE R. FOR MOST PEOPL
E,
(SIN K- A -P E MP, TH EN S O ON RE
SYNCOPE NSCIOUS AND GO LI
HAVE SYNCOPE IF T
H EY B EC O M E U NC O
IS N O T A SI G N O F SERIOUS ILLNESS
.
, AND
U RS O NC E IN A GR EAT WHILE, IF EVER
SYNCOPE OCC
 ARTICLE
• SYNCOPE DESCRIBES A SUDDEN AND BRIEF TRANSIENT LOSS OF CONSCIOUSNESS (TLOC) WITH POSTURAL FAILURE DUE TO
CEREBRAL GLOBAL HYPOPERFUSION. THE TERM TLOC IS USED WHEN THE CAUSE IS EITHER UNRELATED TO CEREBRAL
HYPOPERFUSION OR IS UNKNOWN. THE MOST COMMON CAUSES OF SYNCOPAL TLOC INCLUDE: (1) CARDIOGENIC SYNCOPE (CARDIAC
ARRHYTHMIAS, STRUCTURAL CARDIAC DISEASES, OTHERS); (2) ORTHOSTATIC HYPOTENSION (DUE TO DRUGS, HYPOVOLEMIA,
PRIMARY OR SECONDARY AUTONOMIC FAILURE, OTHERS); (3) NEURALLY MEDIATED SYNCOPE (CARDIOINHIBITORY, VASODEPRESSOR,
AND MIXED FORMS). RARELY NEUROLOGIC DISORDERS (SUCH AS EPILEPSY, TRANSIENT ISCHEMIC ATTACKS, AND THE SUBCLAVIAN
STEAL SYNDROME) CAN LEAD TO CEREBAL HYPOPERFUSION AND SYNCOPE. NONSYNCOPAL TLOC MAY BE DUE TO NEUROLOGIC
(EPILEPSY, SLEEP ATTACKS, AND OTHER STATES WITH FLUCTUATING VIGILANCE), MEDICAL (HYPOGLYCEMIA, DRUGS), PSYCHIATRIC,
OR POST-TRAUMATIC DISORDERS. BASIC DIAGNOSTIC WORKUP OF TLOC INCLUDES A THOROUGH HISTORY AND PHYSICAL
EXAMINATION, AND A 12-LEAD ELECTROCARDIOGRAM (ECG). BLOOD TESTING, ELECTROENCEPHALOGRAM (EEG), MAGNETIC
RESONANCE IMAGING (MRI) OF THE BRAIN, ECHOCARDIOGRAPHY, HEAD-UP TILT TEST, CAROTID SINUS MASSAGE, HOLTER
MONITORING, AND LOOP RECORDERS SHOULD BE OBTAINED ONLY IN SPECIFIC CONTEXTS. MANAGEMENT STRATEGIES INVOLVE
PHARMACOLOGIC AND NONPHARMACOLOGIC INTERVENTIONS, AND CARDIAC PACING.
IS THERE LOSS OF CONSCIOUSNESS IN SYNCOPE?

• SYNCOPE IS A TEMPORARY LOSS OF CONSCIOUSNESS THAT HAPPENS DUE TO A DECREASE IN BLOOD

FLOW TO YOUR BRAIN. IT'S MORE COMMONLY KNOWN AS FAINTING. FAINTING ACCOUNTS FOR BETWEEN
3 AND 5 PERCENT OF EMERGENCY ROOM VISITS IN THE UNITED STATES.
 WHAT IS THE DIFFERENCE BETWEEN LOSS
OF CONSCIOUSNESS AND SYNCOPE?

• SYNCOPE AND VARIANTS DEFINED: SYNCOPE (FAINT) IS OFTEN CONSIDERED

AS A SUBSET OF THE SYMPTOM OF TRANSIENT LOSS OF CONSCIOUSNESS (OR
IN OTHER WORDS, PASSING OUT). USING THIS DEFINITION SYNCOPE IS THE
MOST COMMON -- ACCOUNTING FOR ABOUT 80% -- OF THE 3 CONDITIONS THAT
CAUSE TRANSIENT LOSS OF CONSCIOUSNESS.
 VASOVAGAL SYNCOPE

• VASOVAGAL SYNCOPE HAS THREE DISTINCT PHASES: A PRODROME, LOSS OF CONSCIOUSNESS, AND A
POSTSYNCOPAL PHASE. A PRECIPITATING EVENT OR SITUATION (E.G., EMOTIONAL STRESS, TRAUMA, PAIN,
SIGHT OF BLOOD, PROLONGED STANDING) USUALLY IS IDENTIFIABLE.