Causes for syncope
Syncope is a brief, usually spontaneous loss of consciousness that occurs due to reduced blood supply to the brain. The causes of syncope are varied and can have both cardiac and non-cardiac causes. Here are the main causes with their approximate percentage incidence:
Vasovagal syncope (30-50%): Also known as "fainting", this is the most common type of syncope. It occurs when the parasympathetic nervous system becomes overly activated, causing sudden vasodilation or an extremely slow heartbeat. This can be triggered by emotions, pain, anxiety, heat, dehydration or prolonged standing.
- Orthostatic hypotension (10-30%): It occurs when a person stands up quickly, which causes a decrease in cerebral blood flow and can lead to syncope. Certain medications, autonomic nervous system disorders or diseases such as Parkinson's or diabetes can increase the risk of orthostatic syncope.
- Cardiogenic shock (5-10%): A condition that occurs when the heart is unable to pump enough blood around the body, resulting in a lack of oxygen and nutrients to the brain.
- Arrhythmias (5-10%): Bradycardic (slow) but also tachycardic (fast) arrhythmias can cause the heart to not pump blood effectively through the body. For example, asystole (absence of a heartbeat) and ventricular fibrillation lead to loss of consciousness after less than 10 seconds.
- Structural heart disease (5-10%): Such as aortic valve stenosis, hypertrophic cardiomyopathy, pericardial tamponade or pulmonary embolism, can also lead to syncope.
- Neurological causes (5-10%): e.g. epilepsy, stroke, migraine or brain tumours, can cause syncope.
- Other causes (5-10%): such as hypoglycaemia, poisoning or anaemia.
It should be noted that the percentage incidence may vary according to age and sex.
Syncope is doubly dangerous: on the one hand due to the underlying disease, which can be life-threatening if undetected and untreated, and on the other hand due to the high potential for injury as a result of falls.
Syncope is a medical diagnosis, which is made by a doctor. In the meantime, however, everyday technical devices - such as an Apple Watch - can also provide the
such as an Apple Watch - can provide initial indications of the presence of a cardiac arrhythmia.
Do you have a finding and would like a second opinion or are you not sure if you suffer from syncope? One of our specialists will be happy to take the time for a consultation.
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Diagnosis
Syncope diagnosis is complex and should be carried out in experienced centres. It includes a detailed analysis of the causes, which, in addition to a detailed medical history, includes cardiovascular examinations of the structure (anatomy) and function of the cardiovascular system. Thanks to our interdisciplinary working concept, we can also use the expertise of other medical disciplines such as neurology, diabetology, endocrinology and laboratory medicine in the analysis of rare causes of syncope at any time. In our centre, we have established all the usual examination procedures for successful syncope diagnosis, including echocardiography, ambulatory blood pressure measurement and various function tests, as well as a complex rhythm analysis. In addition to electrocardiographic examination methods such as ECG and long-term ECG (up to 30 days), this also includes the implantation of small event recorders that can be implanted under the skin. These devices can seamlessly document abnormalities of the heart rhythm over a period of up to 4 years.
Treatment
Once the diagnosis is confirmed, we create an individual treatment plan for each patient. This may include drug therapy, implantation of a pacemaker but also other treatment options to alleviate your symptoms and improve your quality of life. Our goal is to provide you with the best possible care and guide you on the road to a speedy and successful recovery. We invite you to visit us at our heart clinic and look forward to helping you improve your heart health.
FAQs
What is syncope, and is it dangerous?
Syncope is a brief, usually sudden loss of consciousness caused by a reduced blood supply to the brain. It should be taken seriously for two reasons: First, the underlying cause may be life-threatening if left undiagnosed; second, there is an increased risk of injury due to a possible fall. Therefore, syncope should always be evaluated by a doctor.
What can cause syncope?
The most common cause is vasovagal syncope (the classic “fainting spell”), triggered, for example, by strong emotions, pain, anxiety, heat, or dehydration. Other causes include low blood pressure when standing up quickly (orthostatic hypotension), cardiac arrhythmias, structural heart disease, neurological conditions such as epilepsy or stroke, and other factors such as hypoglycemia or anemia. In cases of arrhythmia, even a brief pause in the heartbeat lasting just a few seconds can lead to loss of consciousness.
How is the cause diagnosed and treated?
The evaluation includes a detailed medical history, a physical and cardiovascular examination, echocardiography, blood pressure measurement, and an ECG or Holter monitor (up to 30 days). If necessary, an implantable event recorder is used, which can record cardiac arrhythmias for up to 4 years. Depending on the cause, treatment is tailored to the individual—ranging from medication to the implantation of a pacemaker—often in collaboration with neurology or other specialties. In Switzerland, basic health insurance covers consultations, second opinions, and treatment.
