Syncope is defined as a transient loss of consciousness due to the decrease in perfusion of the brain stem.

The most common form of syncope is vasoovagal.

It can be triggered by pain, fear or anxiety. It is worsened by intake of food, crowds, heat, or alcohol.

It occurs only when the patient is sitting or standing (NOT LYING DOWN). It usually affects young people. It is preceded by total symptoms like nausea, epigastric discomfort, sweating, feeling of heat followed by loss of consciousness. It is short lasting. And if the patient is part in the lying position, the patient regains consciousness. During the episode, the heart rate is slow and the pressure is low. The patient should not try to get up immediately otherwise the episode may recur.

Cardiac syncope may result from the structural lesions or arrhythmias and can be fatal therefore need admission and monitoring.

Well-known mechanical/structural causes include aortic stenosis, idiopathic hypertrophic sub aortic stenosis.

One cause that commonly appears on exams is atrial myxoma. But telltale sign that is given out in the test is an atrial plop and sometimes associated with it are signs of infective endocarditis. ESR may be elevated. A murmur of mitral stenosis may be heard.