Fainting (Syncope)

Syncope is the medical term for a temporary loss of consciousness, commonly known as fainting. It occurs when there is a sudden, temporary drop in blood flow to the brain, resulting in a brief blackout.

While many fainting episodes are non-life-threatening, syncope can be a critical indicator of an underlying heart condition that requires specialist cardiac evaluation.

Recognising ‘Pre-Syncope’

Most patients experience warning signs before losing consciousness. Recognising these symptoms early can help you find a safe position and prevent injury:

• Sudden lightheadedness or dizziness.
• Blurred or “tunnel” vision.
• Nausea or a sudden feeling of warmth.
• Cold, clammy skin or breaking out in a cold sweat.
• Heart palpitations or a “fluttering” sensation in the chest.

• Vasovagal Syncope (Reflex Syncope): The most common form, often triggered by emotional distress, the sight of blood, or standing for extended periods of time.

• Situational Syncope: A reflex response that occurs during specific functions, such as coughing, sneezing, or swallowing.

• Cardiac Syncope: The most serious category, caused by heart issues that prevent oxygenated blood from reaching the brain. This includes arrhythmias (irregular heartbeats), structural heart disease, or aortic stenosis.

If you have experienced a blackout, a medical review is essential to rule out cardiac complications. You should seek an urgent specialist consultation if:

• You have fainted more than once in a short period. 

• Fainting occurred during physical exercise or exertion. 

• You have a known history of heart disease.
  
  
• The episode occurred suddenly, without any ‘pre-syncope’ warning signs. 
  
  
• You experienced chest pain or palpitations immediately before fainting.

Your cardiologist may recommend one or more of the following tests:

• ECG (Electrocardiogram): Checks your heart rhythm and can help detect heart attacks or rhythm problems.

• Echocardiogram: An ultrasound scan assessing heart function and valve movement.

• Holter Monitor: A portable device for continuous heart rhythm monitoring over 24-48 hours or more.

• Tilt Table Test: To monitor how heart rate and blood pressure react to changes in position.

• Blood Tests: To rule out secondary causes like anaemia or electrolyte imbalances.