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Cardiovascular Health Q3 2023

Take fainting to heart — there is no such thing as a simple faint

iStock / Getty Images Plus / Madrolly

Trudie Lobban MBE FRCP

Founder, STARS (Syncope Trust and Reflex Anoxic), Arrhythmia Alliance

Fainting (syncope) affects one in two people at least once during their lifetime. This unexplained loss of consciousness is a common yet overlooked symptom of an underlying, potentially fatal, heart rhythm disorder.

Many people may faint due to low blood pressure, dehydration or heat-related syncope. However, for others, something more serious can be causing the sudden loss of consciousness.  

Fainting can be a sign of underlying heart condition 

Any unexplained loss of consciousness or fainting should be investigated, and an electrocardiogram (ECG) should be undertaken and analysed by a heart rhythm specialist (electrophysiologist). Fainting should never be ignored as it can be a sign of an underlying, potentially fatal, heart rhythm condition. If you experience syncope that occurs without warning or is preceded by a racing heart rate, consult your GP urgently.  

There is no such thing as a simple faint 

Fainting is sometimes the only symptom before sudden cardiac death. While many arrhythmias (heart rhythm disorders) are nothing to worry about (after all, we all experience palpitations sometimes), others can prove fatal. Long QT and Brugada are arrhythmia syndromes that can present as ‘simple faints’ leading to sudden death.   

Sadly, cases could have been easily identified and prevented with a simple ECG and treatment. Both conditions are genetic, so close family members should also be investigated for a history of fainting. Not everyone with Long QT or Brugada experiences fainting episodes — some have no symptoms and die suddenly. 

If you experience ‘simple faints,’ don’t
delay — get checked straight away.

Support for syncope  

STARS (Syncope Trust And Reflex anoxic Seizures) is the only organisation providing information and support to people affected by unexplained loss of consciousness. They have a checklist you can download and share with your GP.  

During initial assessment, your GP will take a history of your condition and conduct a physical examination, including a blood pressure reading and standard ECG. The Blackouts Checklist, developed under the guidance of STARS’ expert Medical Advisory Committee, will help you prepare for your appointments and equip you with the right questions.   

Taking charge of your diagnosis 

Unexplained loss of consciousness is traumatic; however, there are ways to manage your condition. Consult your doctor for self-care measures to help manage vasovagal syncope and postural tachycardia syndrome (PoTS), such as isometric counterpressure exercises, compression garments and trigger avoidance.  

Additionally, you can join patient-to-patient support groups to learn more about your condition and meet other affected individuals. Get the knowledge to support you throughout your care pathway. If you experience ‘simple faints,’ don’t delay — get checked straight away.   

Download the Blackout Checklist on to share with your GP for initial assessment. For 30 years, STARS has supported patients affected by an unexplained loss of consciousness to receive the correct diagnosis and appropriate treatment.

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