Syncope and Blackouts


Syncope is the term used to describe a transient loss of consciousness. This is a common cause for a referral to a cardiologist and repeated episodes can be both dangerous and debilitating. If you have an episode of syncope you should seek the advice of a trained medical professional. Many cases of syncope are termed "vasovagal" and these are akin to a simple faint. With vasovagal syncope the diagnosis can be made on history alone however commonly a 24 hour cardiac monitor, an echocardiogram and a tilt table test are also helpful. Often ensuring adequate hydration and salt intake is sufficient to prevent significant ongoing episodes. Occasionally medications are required and very rarely a pacemaker is helpful.

There are a broad range of other causes of syncope and  it is important to exclude cardiac rhythm disturbances and structural heart disease as potentially serious underlying cardiac causes.

Heart Block

Significant electrical conduction disturbances within the heart (heart block) are important to detect, as this can be life threatening if left untreated. Treatment with a pacemaker is highly effective. Heart block is a disease usually associated with ageing, however it can be a congenital condition or acquired, secondary to other medical conditions or pharmacological treatments.

Ventricular Arrhythmias

Fast heart rhythms originating from the bottom chambers of the heart always need investigating and frequently can be life threatening. These may occur in an otherwise normal heart but more commonly occur in hearts with heart muscle disease (cardiomyopathy) and/or coronary artery disease. If a ventricular arrhythmia causes syncope frequently an Implantable Defibrillator is required. It is usually also necessary for such patients to remain on long term medication. Some patients may benefit from an ablation procedure. In patients with an otherwise healthy heart and no significant symptoms from their ventricular arrhythmia it may be that no treatment is required, however often medication and an ablation may be recommended.

Dr Hickman sees private and NHS patients referred by their general practitioners and a referral letter is usually required. In exceptional circumstances, due to the urgent and unpredictable nature of cardiac complaints, Dr Hickman will offer urgent appointments to private patients without a referral letter. A full report will subsequently be sent to their GP.

ECG showing heart block and failure of electrical conduction from atria to ventricles.