Syncope is a temporary loss of consciousness usually related to insufficient blood flow to the brain.
It most often occurs when blood pressure is too low (hypotension) and the heart doesn't pump enough oxygen to the brain. It can be benign or a symptom of an underlying medical condition. several serious heart conditions, such as bradycardia, tachycardia or blood flow obstruction, can also cause syncope.
Cardiac or cardiovascular syncope is caused by various heart conditions, such as bradycardia, tachycardia or certain types of hypotension. It can increase the risk of sudden cardiac death.
People suspected of having cardiac syncope but who don't have serious medical conditions may be managed as outpatients. Further inpatient evaluation is needed if serious medical conditions are present. Conditions that may warrant hospital evaluation and treatment include various cardiac arrhythmic conditions, cardiac ischemia, severe aortic stenosis and pulmonary embolism. If evaluation suggests cardiac vascular abnormalities, an ambulatory external or implantable cardiac monitor may be required.
Heart failure, atrial fibrillation and other serious cardiac conditions can cause recurrent syncope in older adults, with a sharp increase after age 70.
Syncope is common, but adults over age 80 are at greater risk of hospitalization and death.
Younger people without cardiac disease but who've experienced syncope while standing or have specific stress or situational triggers aren't as likely to experience cardiac syncope.
Cardiac syncope is a higher risk in: people older than age 60; men; presence of known heart disease; brief palpitations or sudden loss of consciousness; fainting during exertion; fainting while supine; an abnormal cardiac exam; or family history of inheritable conditions. Other existing conditions and medications used are particularly important in older patients.
