Facts About Synope

Other names: fainting, passing out

What is syncope?
Syncope, or fainting, is a sudden, temporary loss of consciousness.

What causes syncope?
Syncope is caused by a temporary decrease in the flow of blood to the brain. A large number of situations or conditions can cause this decrease in blood flow. They can include: straining for a prolonged period, common mild illnesses like cold and flu, standing up quickly, emotional stress, heart disease, standing rigidly for a long time, arrhythmias (abnormal heart beats), pain, fright, drugs and alcohol.

Certain heart conditions can cause syncope. They indude: heart attacks, certain arrhythmias (irregular heartbeats), hypertropic cardiomyopathy (a rare disease that involves a "thickening" of the heart muscle), disorders of the heart valves, or heart block (a problem with the heart's electrical system that produces very slow heart beats).

How to the cause of syncope diagnosed?
The doctor will start with a thorough physical exam and review of your medical history. The doctor may recommend certain diagnostic tests to determine the cause of your fainting episodes. These tests might include: X-rays, use of a Holler monitor (a device that you wear during the day that records the electrical activity over a period of time), or other diagnostic or imaging testing procedures.  Your doctor might recommend a "tilt-table test". This test involves a special table that tilts upright.  Sometimes, medications are given during the test to help with the diagnosis.

How is syncope treated?
Treatment depends on the cause of the fainting spells. If the problems are related to a heart condition, then the heart condition is treated. If the problem is related to medications, the doctor may change the dosage or the type of medication. Medications are generally not required to treat syncope, but they might be required to treat the cause of syncope.

Most fainting spells are not dangerous. Individuals usually regain consciousness on their own in a few minutes.

The method by which a small mechanically driven cutter shaves the plaque from the artery wall. The catheter is placed over a guide wire to the narrowed segment. Balloon angioplasty may be done before and after the atherectomy. The different types of atherectomy catheters that may be used:

  • Rotational Atherectomy uses an abrasive diamond coated burr at the tip of the catheter. The catheter is rotated rapidly (like a dental drill) to grind or sand the plaque into tiny particles that float away in the blood stream.
  • Extraction Atherectomy uses a rotating blade inside the tip of the catheter to cut the plaque. The plaque is then vacuumed into the catheter and removed.
  • Directional Atherectomy uses a catheter with a windowed chamber over a rotating blade. The window is placed over the blockage. The rotating blade shaves the plaque and collects it in the catheter tip.

The method by which a sonogram (ultrasound) catheter is placed in the diseased artery. As the catheter is pulled back, sonogram pictures are taken. This is used to determine the level of blockage and the size of the artery.

Most procedures are done on an outpatient basis or may require a one-night stay in the hospital. Patients recover quickly and can resume normal activities sooner than with traditional surgery.  If the blockage is extremely long or has become very hard and calcified with time, it may be resistant to any of these interventions. In these cases, surgery may be required. Surgery typically consists of either a "bypass" procedure (which uses a section of blood vessel taken from elsewhere in the body, then sewn into place to "bypass" the blocked portion of artery), "grafting" (repair or replacement of the vessel), or "endarterectomy" (removal of the lining of the artery, which removes the plaque). Surgery is usually performed only on severe cases where the ability to work or pursue essential activities is affected.

Medications may be required to control the disorder, including analgesics to control pain, pentoxtfylline (in some cases), and medications such as cholestyramine to reduce total cholesterol levels.

Exercise is an important part of your treatment and recovery. Your doctor will provide you with specific instructions on exercise following your procedure. Over time, circulation improves because of the development of collateral (new, small) blood vessels.