Syncope (say "SING-kuh-pee") refers to a sudden loss of consciousness
that soon passes. Syncope may be the first indication that you have an
arrhythmia and is a very worrisome symptom for several
reasons:
- Passing out can cause a serious injury. For
example, passing out while climbing the stairs or while driving can cause
serious harm.
- If you pass out because your brain did not get enough
oxygen to function, this may be a warning sign that you have a serious medical
condition.
An arrhythmia can cause syncope in the same way that it causes
lightheadedness (presyncope)—your heart cannot pump blood effectively during
excessively fast (tachycardia) or slow (bradycardia) heart rates, reducing the
amount of blood that reaches your brain.
With syncope, though, the arrhythmia causes such a dramatic drop in
the blood pressure that the brain does not receive enough blood to keep you
conscious, and you lose consciousness as a result. For an arrhythmia to cause
syncope, your heart rate must be extremely fast or extremely slow, or you must
have some other heart condition in addition to the arrhythmia.
How long does syncope last?
It is important to recognize that syncope is transient, meaning
that you wake up soon after passing out. You may wake up because the arrhythmia
stops on its own and a normal rhythm and blood pressure return. Even if the
arrhythmia persists, you may still regain consciousness. When you have an
episode of syncope due to an arrhythmia, it typically happens while you are
standing or sitting, and the loss of consciousness causes you to fall to the
floor. As soon as you are lying down, blood flows back into your brain, even
though your blood pressure may remain low. When enough blood flows back into
your brain, you will likely wake up.
What are the risks associated with passing out from an arrhythmia?
Fast or slow arrhythmias may cause you to pass out. Depending on
your position and activity at the time of the episode, you may seriously injure
yourself. If you are standing up at the time of the arrhythmia, you may pass
out and fall, which may cause you to injure your head, break an arm or leg, or
receive other injuries. If you are driving, you may crash, causing severe
injury to yourself and anyone else involved.
Passing out may be a sign that you are at risk for a
life-threatening arrhythmia. If you have symptoms of an arrhythmia that may
cause you to pass out, do not drive any vehicle until your condition has been
evaluated and treated.
When is lightheadedness not caused by bradycardia?
Many of the medicines used to treat heart conditions, such as
beta-blockers, calcium channel blockers, ACE inhibitors, and diuretics, can
lower the blood pressure excessively and result in lightheadedness. In general,
medicine-induced lightheadedness often occurs soon after you stand up
(orthostasis) because of the drop in blood pressure that happens when you stand
(orthostatic hypotension). In contrast, lightheadedness cause by an arrhythmia
can occur even when you are sitting or reclining.
Other causes of lightheadedness include hyperventilation, panic or
anxiety attacks, prolonged standing, and excessive fluid loss caused by
vomiting, diarrhea, or sweating.